What are the differential diagnoses for hepatic (liver) disease?

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Last updated: February 27, 2025View editorial policy

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Differential Diagnosis for Liver Disease

The following differential diagnosis is organized into categories to help guide the thought process and ensure that all potential causes are considered.

  • Single Most Likely Diagnosis
    • Viral Hepatitis: This is often the most common cause of liver disease, particularly in individuals with a history of exposure to hepatitis A, B, or C. The diagnosis can be confirmed with serological tests and liver function tests.
  • Other Likely Diagnoses
    • Alcoholic Liver Disease: A common cause of liver disease in individuals with a history of heavy alcohol use. The diagnosis can be supported by liver function tests, imaging studies, and a history of alcohol use.
    • Non-Alcoholic Fatty Liver Disease (NAFLD): A common cause of liver disease in individuals with obesity, diabetes, and dyslipidemia. The diagnosis can be supported by liver function tests, imaging studies, and a history of metabolic syndrome.
    • Autoimmune Hepatitis: A cause of liver disease in individuals with a history of autoimmune disorders. The diagnosis can be supported by liver function tests, autoantibody tests, and a liver biopsy.
  • Do Not Miss Diagnoses
    • Wilson's Disease: A rare genetic disorder that can cause liver disease and neurological symptoms. It is essential to consider this diagnosis in young individuals with liver disease and neurological symptoms.
    • Budd-Chiari Syndrome: A rare disorder caused by thrombosis of the hepatic veins, which can lead to liver failure. It is essential to consider this diagnosis in individuals with liver disease and thrombophilia.
    • Acetaminophen Toxicity: A common cause of liver failure, particularly in individuals with a history of overdose or chronic use of acetaminophen. It is essential to consider this diagnosis in individuals with liver failure and a history of acetaminophen use.
  • Rare Diagnoses
    • Primary Biliary Cholangitis: A rare autoimmune disorder that causes destruction of the bile ducts and liver disease. The diagnosis can be supported by liver function tests, autoantibody tests, and a liver biopsy.
    • Primary Sclerosing Cholangitis: A rare disorder that causes inflammation and scarring of the bile ducts and liver disease. The diagnosis can be supported by liver function tests, imaging studies, and a liver biopsy.
    • Hemochromatosis: A rare genetic disorder that causes iron overload and liver disease. The diagnosis can be supported by liver function tests, iron studies, and a liver biopsy.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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