Hepatocellular Liver Injury - Differential Diagnosis Framework:

Liver Injury → liver test abnormalities without evidence of liver failure

1) Hepatocellular (disproportionate increase in AST/ALT compared with alkaline phosphatase)

2) Cholestatic (disproportionate increase in alkaline phosphate compared with AST/ALT)

Hepatocellular Liver Injury Differential Diagnosis:

 • Infections: Hepatitis A/B/C/D/E, EBV, CMV, HSV, VZV

 • Medications (APAP, PTU, isoniazid, phenytoin, valproate, azoles), Drugs (MDMA), Alcohol, Iron, Mushrooms (Amanita phalloides)

 • Vascular: Ischemic, Congestion, Budd Chiari

 • Hereditary: Hemochromatosis, Wilson's disease, Alpha-1 antitrypsin

 • Other: NAFLD, Autoimmune, HELLP, Celiac disease, Malignancy



by Lauren Banaszak, MD @LaurenBzak via @uw_IMresidency



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