Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins • Ischemia • Autoimmune • Wilson's • Pregnancy - AFLP, HELLP Moderate ALT 5-15x ULN • Viral • Drugs • Wilson's • Hemochromatosis • NAFLD • Others Mild ALT < 5x ULN • NAFLD • Alcohol • Viral • Hemochromatosis • Drugs • AIH • A1AT deficiency • Wilson's • Others • Cholestatic disease US — Normal Bile Ducts • PSC • Alcoholic hepatitis • Drugs • TPN • Sepsis • Infiltrative • Cirrhosis (any) • Congenital US - Dilated Bile Ducts • Common Bile Duct Stone • Biliary stricture • Worms/flukes • Cholangiocarcinoma • Pancreatic cancer • Others #LFTs #Hepatology #LiverEnzymes #Differential #Diagnosis #Algorithm #Causes
