Differential Diagnosis for Transaminitis with Low Platelets
Single Most Likely Diagnosis
- Viral Hepatitis: This is a common cause of transaminitis and can be associated with thrombocytopenia (low platelets) due to the body's immune response to the virus. Viral hepatitis can be caused by hepatitis A, B, C, D, or E viruses, with hepatitis C being a notable cause of chronic liver disease.
Other Likely Diagnoses
- Drug-Induced Liver Injury (DILI): Many medications and supplements can cause liver injury, leading to transaminitis. Some drugs may also cause thrombocytopenia, making DILI a plausible diagnosis in patients with these symptoms.
- Autoimmune Hepatitis: This condition occurs when the body's immune system attacks liver cells, causing inflammation and liver damage. Autoimmune hepatitis can be associated with thrombocytopenia and is more common in women.
- Primary Biliary Cholangitis (PBC): PBC is an autoimmune disease that causes progressive destruction of the bile ducts within the liver, leading to liver damage and potentially thrombocytopenia.
Do Not Miss Diagnoses
- Wilson's Disease: Although rare, Wilson's disease is a genetic disorder that leads to copper accumulation in the liver, causing liver damage and potentially life-threatening complications if not treated. Thrombocytopenia can occur due to splenic sequestration from portal hypertension.
- Budd-Chiari Syndrome: This condition involves thrombosis of the hepatic veins, which can cause liver dysfunction, transaminitis, and thrombocytopenia due to splenic sequestration from portal hypertension. It is crucial to diagnose and treat promptly to prevent severe complications.
- Hemophagocytic Lymphohistiocytosis (HLH): HLH is a rare but life-threatening condition characterized by an overactive and inappropriate immune response, leading to liver dysfunction, thrombocytopenia, and other systemic symptoms.
Rare Diagnoses
- Glycogen Storage Diseases: Certain glycogen storage diseases, such as type I glycogen storage disease, can cause liver dysfunction and thrombocytopenia due to splenic enlargement.
- Gaucher's Disease: This genetic disorder leads to the accumulation of glucocerebroside in various organs, including the liver and spleen, potentially causing liver dysfunction and thrombocytopenia.
- Lymphoma: Although less common, certain types of lymphoma can cause liver involvement and thrombocytopenia, either through direct liver infiltration or secondary to splenic sequestration.