Differential Diagnosis for Liver Enzyme Elevation in an 8-Month-Old Female with Bronchiolitis
Single Most Likely Diagnosis
- Viral hepatitis: The patient is already infected with multiple viruses (parainfluenza virus, adenovirus, human metapneumovirus, and rhinovirus), which could potentially cause liver enzyme elevation due to viral hepatitis.
Other Likely Diagnoses
- Medication-induced liver injury: The patient may be receiving medications for her bronchiolitis, such as acetaminophen or ibuprofen, which can cause liver enzyme elevation.
- Metabolic disorders: Certain metabolic disorders, such as mitochondrial disorders or fatty acid oxidation disorders, can present with liver enzyme elevation and may be exacerbated by illness.
- Congenital infections: Congenital infections, such as congenital CMV or toxoplasmosis, can cause liver enzyme elevation and may not have been previously diagnosed.
Do Not Miss Diagnoses
- Biliary atresia: A condition where the bile ducts are blocked, leading to liver damage and enzyme elevation. Although rare, it is a serious condition that requires prompt diagnosis and treatment.
- Neonatal hemochromatosis: A condition where there is excessive iron accumulation in the liver, leading to liver damage and enzyme elevation.
- Sepsis: Bacterial sepsis can cause liver enzyme elevation and is a life-threatening condition that requires prompt diagnosis and treatment.
Rare Diagnoses
- Alpha-1 antitrypsin deficiency: A genetic disorder that can cause liver enzyme elevation and liver disease.
- Glycogen storage diseases: A group of genetic disorders that can cause liver enzyme elevation and liver disease.
- Wilson's disease: A genetic disorder that can cause liver enzyme elevation and liver disease due to excessive copper accumulation.
- Autoimmune hepatitis: A condition where the immune system attacks the liver, leading to liver enzyme elevation and liver damage.