Differential Diagnosis for Elevated GGT
Elevated Gamma-Glutamyl Transferase (GGT) is a laboratory finding that can be associated with various conditions. The differential diagnosis can be categorized as follows:
- Single Most Likely Diagnosis
- Alcoholic liver disease: This is often the most common cause of elevated GGT, as alcohol consumption can induce the enzyme's production in the liver.
- Other Likely Diagnoses
- Non-alcoholic fatty liver disease (NAFLD): GGT elevation can be seen in patients with NAFLD, especially those with more severe forms like non-alcoholic steatohepatitis (NASH).
- Bile duct obstruction: Conditions such as gallstones, tumors, or strictures can cause elevated GGT due to increased synthesis in the bile ducts.
- Pancreatic disease: Pancreatitis or pancreatic cancer can lead to elevated GGT levels.
- Medication-induced liver injury: Certain medications, such as statins or anticonvulsants, can cause liver damage and subsequent GGT elevation.
- Do Not Miss Diagnoses
- Primary biliary cholangitis (PBC): Although less common, PBC is a progressive liver disease that can present with elevated GGT and requires early diagnosis and treatment.
- Primary sclerosing cholangitis (PSC): This rare condition involves inflammation and scarring of the bile ducts and can cause elevated GGT.
- Hepatocellular carcinoma: Although rare, liver cancer can cause elevated GGT, and early detection is crucial for treatment.
- Rare Diagnoses
- Gilbert's syndrome: A benign condition characterized by mild intermittent jaundice, which can sometimes present with elevated GGT.
- Dubin-Johnson syndrome: A rare genetic disorder that affects the liver's ability to transport bilirubin, leading to elevated GGT.
- Rotor syndrome: A rare, benign condition similar to Dubin-Johnson syndrome, which can cause elevated GGT.