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Liver Screening

Liver health matters. Learn when you should get screened and what tests are involved.

Liver Follow-Up
Argyropoulos Theodoros, M.D., M.Sc., Ph.D.
Senior Registrar in Gastroenterology, G.N.A. “G. Gennimatas”
Scientific Director, Gastroenterology Department – Affidea Peristeri

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What is liver screening?

Liver screening is a set of blood and clinical tests that assess the function of the liver and the biliary system.

It is a valuable diagnostic tool used by the gastroenterologist to detect inflammation, fatty infiltration, viral infections, cholestatic diseases, or early signs of liver failure.

The liver is a vital organ with dozens of functions — from detoxifying the body and regulating metabolism, to synthesizing proteins and clotting factors.

Any disturbance in its function can affect the entire organism.

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When is liver screening needed?

Dr. Argyropoulos Theodoros recommends liver screening in the following cases:

 

  • Appearance of jaundice (yellowing of the skin or eyes)
  • Unexplained fatigue or loss of appetite
  • Abdominal pain or pressure sensation in the right upper quadrant
  • Elevated liver enzymes in previous testing
  • Use of medications or alcohol that burden the liver
  • Obesity or diabetes mellitus (risk of fatty liver)
  • History of hepatitis or hereditary liver diseases
  • Preventive screening in individuals with a family history of liver disease
How is liver screening performed?

The examination is simple and painless.
A blood sample is required after 6–8 hours of fasting.
In certain cases, additional imaging (liver ultrasound or magnetic cholangiography) is recommended for a complete assessment of the liver’s morphology and function.

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Main Groups of Tests

4.1 Liver Function Enzymes

Η αύξηση των ενζύμων αποτελεί ένδειξη κυτταρικής βλάβης ή χολόστασης:

Test Description Interpretation
SGOT (AST) Enzymatic marker of cell damage Increased in hepatitis, cirrhosis, muscle injury
SGPT (ALT) More specific marker of liver injury High values → active inflammation
ALP Enzymatic marker of cholestasis Increased in obstruction or biliary tumors
γ-GT Often elevated in cholestasis or alcoholic liver disease Marker of alcohol consumption
5-NU Specialized biliary enzyme Used to confirm cholestasis
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4.2 Bilirubin

Bilirubin is a pigment derived from the breakdown of red blood cells.
Its elevation causes jaundice and may be due to:

  • Hemolysis (excessive destruction of red blood cells)
  • Liver dysfunction (impaired processing)
  • Obstruction of the bile ducts

The tests performed are:

  • Total Bilirubin
  • Direct Bilirubin
  • Indirect Bilirubin
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4.3 Proteins and Albumin

  • The liver produces several important proteins:
  • Albumin → the main plasma protein. Low levels indicate chronic liver disease or malnutrition.
  • Total proteins → evaluate the liver’s overall protein synthesis capacity.

4.4 Additional Tests

  • Depending on the patient’s profile:
  • Viral hepatitis screening (HBsAg, Anti-HCV)
  • Prothrombin time (PT) for coagulation assessment
  • Alpha-fetoprotein (AFP) – marker for hepatocellular carcinoma
  • Iron and ferritin levels for potential hemochromatosis
  • Ammonia levels in cases of suspected hepatic encephalopathy
  • Liver ultrasound / elastography to assess fibrosis
  • Common Causes of Liver Dysfunction

• Viral hepatitis (A, B, C, E)
• Fatty liver disease (NAFLD, NASH)
• Cirrhosis
• Drug-induced liver injury (DILI)
• Autoimmune hepatitis
• Alcohol-related liver disease
• Biliary obstruction (choledocholithiasis, strictures)
• Primary liver tumors or liver metastases

  • When is interventional evaluation needed?

In cases where blood tests or imaging indicate obstruction or a suspicious lesion, Dr. Argyropoulos may recommend:

  • ERCP for diagnostic and therapeutic evaluation of the biliary system
  • SpyGlass™ for direct cholangioscopy and targeted biopsies
  • EUS (Endoscopic Ultrasound) for accurate assessment of lesions or masses

All interventional procedures are performed in a specialized clinical setting, with full anesthetic support and advanced endoscopic equipment.

Holistic Approach
Dr. Argyropoulos Theodoros

Dr. Argyropoulos Theodoros evaluates the results in a combined manner, assessing:
• the AST/ALT ratio,
• the presence of cholestasis,
• and the correlation with imaging findings.

A comprehensive interpretation leads to an accurate diagnosis and prevents unnecessary interventions.

The physician’s approach combines:
• evidence-based medical practice,
• personalized follow-up,
• and guidance on dietary and pharmacological interventions.

The goal is to protect liver function and prevent chronic damage, through an integrated care model and continuous patient education.

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If your liver function tests are elevated, you present signs of cholestasis, or you require a comprehensive liver evaluation, schedule a consultation with:

Argyropoulos Theodoros, M.D., M.Sc., Ph.D.
Gastroenterologist – Hepatologist

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