Differential Diagnosis for Jaundice
Given the absence of fibrosis on Liver Elastography, diffuse hepatic parenchymal disease, and no gallstones, the following differential diagnoses are considered:
- Single most likely diagnosis
- Viral hepatitis (e.g., hepatitis A, B, C, D, E): This is a common cause of jaundice with diffuse hepatic parenchymal disease and no fibrosis. The lack of fibrosis suggests an acute or early chronic process.
- Other Likely diagnoses
- Drug-induced liver injury (DILI): Various medications can cause liver damage, leading to jaundice and diffuse hepatic parenchymal disease without fibrosis.
- Autoimmune hepatitis: This condition can present with jaundice and diffuse liver disease, although fibrosis may develop over time.
- Wilson's disease: A genetic disorder that can cause liver damage and jaundice, often without significant fibrosis in early stages.
- Do Not Miss
- Acute liver failure (e.g., due to acetaminophen overdose, ischemia, or other toxins): Although less common, acute liver failure is a life-threatening condition that requires prompt recognition and treatment.
- Budd-Chiari syndrome: Hepatic vein thrombosis can cause jaundice and liver disease, and although it may not always present with fibrosis, it is a critical diagnosis to consider due to its potential for severe consequences.
- Rare diagnoses
- Alpha-1 antitrypsin deficiency: A genetic disorder that can cause liver disease and jaundice, often with a component of diffuse parenchymal disease.
- Glycogen storage diseases: Rare genetic disorders that can affect the liver and cause jaundice, although they are less common and may have specific additional features.
- Lymphoma or other malignancies: Although rare, lymphoma or metastatic disease to the liver can cause jaundice and diffuse liver disease without significant fibrosis.