Liver stiffness score (LSS)

Low AST levels are usually not concerning. However, they may indicate Vitamin B6 Deficiency, End-Stage Liver Disease (Cirrhosis), uremia, diabetic ketoacidosis, and pregnancy.

Elevated AST levels are seen in muscle injury (e.g., strenuous exercise, seizures, myopathies, myocardial infarction or heart failure), tissue damage (severe burns, surgery), liver injury (fatty liver, viral or other infections, malignancy), anorexia or rapid weight change (e.g., >5 kg/week), pancreatitis, gallbladder attack and hemolysis (e.g., hemolytic anemia, splenomegaly).

Several drugs can increase AST including: chronic alcohol, NSAIDs, acetaminophen, oral contraceptives, statins, certain antibiotics, corticosteroids, toxins like lead, mercury, and pesticides.

Low platelets (thrombocytopenia) may reflect reduced marrow production, increased destruction or consumption, splenic sequestration, or dilution. If the result is unexpected or isolated, first consider pseudothrombocytopenia from platelet clumping and confirm with a repeat count or smear.

Common settings include marrow suppression or infiltration (B12/folate deficiency, alcohol, chemotherapy, aplastic or malignant marrow disease), immune or drug-induced thrombocytopenia, infection/sepsis, consumptive microangiopathic processes (DIC, TTP/HUS, HELLP), hypersplenism, and chronic liver disease or portal hypertension.

High platelets (thrombocytosis) are most often reactive / secondary, especially with iron deficiency, inflammation, infection, recent bleeding or surgery, tissue injury, malignancy, or hyposplenism/splenectomy. In these cases, the platelet count often improves when the trigger resolves.

Persistent, unexplained, or marked thrombocytosis raises concern for a clonal myeloid disorder, especially essential thrombocythemia, polycythemia vera, primary myelofibrosis, or CML.

Low albumin is primarily a consequence of illness rather than a cause, and it serves as a late-stage indicator of inflammation. It is frequently observed in chronic or persistent inflammatory states.

Low albumin is also associated with liver disease, kidney disease, diabetes, heart failure, fluid overload, advanced malnutrition (particularly from protein deficiency or malabsorption), severe burns, and occasionally cancer.

Elevated albumin levels occur with dehydration (commonly due to vomiting or diarrhea) and insulin resistance.