Which liver function is affected last as hepatitis progresses?

Which liver function is affected last as hepatitis progresses?

• A. Synthetic function/TPAG
• B. Detoxification
• C. Secretory (bile production)
• D. Storage (glycogen)

Answer: (A)

The liver’s ability to synthesize proteins has a large reserve and tends to be preserved until late in hepatitis. Even when substantial hepatocyte loss has occurred, production of plasma proteins like albumin and coagulation factors can still operate reasonably well, so signs of synthetic failure (such as low albumin or coagulopathy) appear only in advanced disease. In contrast, detoxification and bile-secreting functions are more sensitive to hepatocellular injury and can decline earlier, and glycogen storage is affected as cells are damaged. Therefore, the function most likely to be affected last as hepatitis progresses is the synthetic function.

The liver’s ability to synthesize proteins has a large reserve and tends to be preserved until late in hepatitis. Even when substantial hepatocyte loss has occurred, production of plasma proteins like albumin and coagulation factors can still operate reasonably well, so signs of synthetic failure (such as low albumin or coagulopathy) appear only in advanced disease. In contrast, detoxification and bile-secreting functions are more sensitive to hepatocellular injury and can decline earlier, and glycogen storage is affected as cells are damaged. Therefore, the function most likely to be affected last as hepatitis progresses is the synthetic function.