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In contrast, IGF binding proteins (IGFBPs) capture free IGF-1 and inhibits IGF-1 binding to IGF-1R

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29 Serum liver enzyme activity may be mildly to moderately increased, although it is normal in many cases.28, 29, 30 Abdominal ultrasound often reveals evidence of EHBDO.28, 29, 30 Definitive diagnosis by identification of flukes or fluke eggs in the feces is difficult as small numbers of eggs are shed daily, the eggs have varying morphology at different stages of development, and the eggs are quite small