Differential Diagnosis

The patient's laboratory results show elevated liver enzymes (AST and ALT) with relatively normal kidney function and electrolyte levels. Based on these findings, the following differential diagnoses can be considered:

• Single most likely diagnosis
  • Viral Hepatitis: The significant elevation of AST and ALT suggests liver inflammation, which is consistent with viral hepatitis. The patient's symptoms and other laboratory results would need to be evaluated to determine the specific type of viral hepatitis (e.g., hepatitis A, B, or C).
• Other Likely diagnoses
  • Alcoholic Liver Disease: The elevated liver enzymes could also be indicative of alcoholic liver disease, particularly if the patient has a history of excessive alcohol consumption.
  • Non-Alcoholic Fatty Liver Disease (NAFLD): NAFLD is a common cause of elevated liver enzymes and could be considered, especially if the patient has risk factors such as obesity, diabetes, or metabolic syndrome.
  • Drug-Induced Liver Injury: Certain medications or supplements can cause liver injury, leading to elevated liver enzymes. A thorough medication history would be necessary to investigate this possibility.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
  • Acetaminophen Toxicity: Although the patient's liver enzymes are not extremely elevated, acetaminophen toxicity can cause severe liver damage and should be considered, especially if the patient has a history of acetaminophen use.
  • Wilson's Disease: This rare genetic disorder can cause liver damage and elevated liver enzymes. Although it is unlikely, it is essential to consider Wilson's disease to avoid missing this potentially treatable condition.
• Rare diagnoses
  • Autoimmune Hepatitis: This condition is characterized by liver inflammation and elevated liver enzymes. Although it is less common, autoimmune hepatitis should be considered, especially if the patient has other autoimmune disorders or symptoms.
  • Budd-Chiari Syndrome: This rare condition involves thrombosis of the hepatic veins, which can cause liver damage and elevated liver enzymes. Although it is unlikely, Budd-Chiari syndrome should be considered in patients with unexplained liver enzyme elevations.