Differential Diagnosis for Fatty Liver
Single most likely diagnosis
- Fatty liver disease (steatosis) due to alcohol use or non-alcoholic fatty liver disease (NAFLD): This is the most likely diagnosis given the presentation of "fatty liver," as both conditions are characterized by the accumulation of excess fat in liver cells, which can lead to liver inflammation and scarring over time. The distinction between alcoholic and non-alcoholic fatty liver disease would depend on the patient's history of alcohol consumption.
Other Likely diagnoses
- Non-alcoholic steatohepatitis (NASH): A form of NAFLD where there is not only fat accumulation but also inflammation of the liver. NASH can progress to cirrhosis and is a common cause of liver disease in people with obesity and diabetes.
- Alcoholic hepatitis: Inflammation of the liver caused by excessive alcohol consumption, which can also present with fatty changes in the liver.
- Hepatic steatosis due to other causes (e.g., metabolic syndrome, certain medications): Various conditions and medications can lead to the accumulation of fat in the liver, including metabolic syndrome, which encompasses a cluster of conditions like high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.
Do Not Miss diagnoses
- Wilson's disease: A rare genetic disorder characterized by excessive accumulation of copper in the body, particularly in the liver, brain, and other vital organs. If missed, it can lead to severe liver damage and neurological symptoms.
- Hemochromatosis: A genetic disorder causing the body to absorb too much iron from food, leading to iron overload and potential liver damage, heart problems, and other complications.
- Alpha-1 antitrypsin deficiency: A genetic disorder that may cause lung disease and liver disease, as the lack of this enzyme can lead to the accumulation of abnormal proteins in the liver, causing damage.
Rare diagnoses
- Lipid storage diseases (e.g., Gaucher's disease): A group of rare genetic disorders caused by deficiencies of enzymes required for the metabolism of certain lipids, leading to their accumulation in various organs, including the liver.
- Abetalipoproteinemia: A rare inherited disorder affecting fat absorption and leading to very low levels of certain lipoproteins in the blood, which can cause fatty liver among other symptoms.
- Glycogen storage diseases: A group of inherited disorders characterized by the deficiency of enzymes necessary for glycogen synthesis or breakdown, leading to the accumulation of glycogen in the liver and muscles, which can mimic fatty liver in some cases.