Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
• Severe - ALT >15X ULN
- Drugs, Viral, Ischemia, AIH, Wilsons, Pregnancy - AFLP, HELLP
• Moderate - ALT 5-15X ULN -
- Viral, AIH, Wilson's, HH, NAFLD, Others
• Mild - ALT < 5x ULN
- NAFLD, Alcohol, Viral, HH, AIH, A1AT def, Wilson's, Cholestatic dz
Cholestatic Pattern (ALP > ALT or AST):
• US - Normal Bile Ducts
- PBC, PSC, Alcoholic Hep, Drugs, Infection, Sepsis, Infiltrative, Congenital, Others, Cirrhosis (any)
• US - Dilated Bile Ducts
- CBD stone, Biliary stricture, PSC, Worms/Flukes, Cholangio CA, Pancreatic CA, Others
Dr. Kelly Warren Burak @kwburak
#LFTs #Elevated #Abnormal #Transaminitis #Algorithm #diagnosis #hepatology #LiverFunctionTests
