Differential Diagnosis for Deranged Liver Function Tests in a Young Healthy Male

Single Most Likely Diagnosis

• Alcoholic Liver Disease: This is often the most common cause of abnormal liver function tests in young adults, especially males, due to the potential for alcohol misuse. Even moderate alcohol consumption can lead to liver enzyme elevations.

Other Likely Diagnoses

• Viral Hepatitis (A, B, C, D, E): These infections are common and can cause liver inflammation, leading to deranged liver function tests. Hepatitis B and C are particularly relevant due to their potential for chronic infection.
• Non-Alcoholic Fatty Liver Disease (NAFLD): Although more commonly associated with obesity and metabolic syndrome, NAFLD can occur in lean individuals and is a significant cause of liver dysfunction.
• Drug-Induced Liver Injury (DILI): Various prescription and over-the-counter medications, as well as herbal supplements, can cause liver damage, making this a plausible diagnosis in a young adult with deranged liver function tests.

Do Not Miss Diagnoses

• Wilson's Disease: An autosomal recessive disorder leading to copper accumulation in the liver, which can cause liver dysfunction. It's crucial to diagnose early to prevent irreversible liver damage.
• Autoimmune Hepatitis: A condition where the body's immune system attacks liver cells, leading to inflammation and liver damage. Early diagnosis and treatment are vital to prevent cirrhosis.
• Hemochromatosis: A genetic disorder causing excessive iron absorption, leading to iron overload and potential liver damage. Identifying this condition is critical to prevent long-term complications.

Rare Diagnoses

• Alpha-1 Antitrypsin Deficiency: A genetic disorder that may cause liver disease and lung disease due to the accumulation of abnormal alpha-1 antitrypsin protein in the liver.
• Budd-Chiari Syndrome: A rare condition caused by occlusion of the hepatic veins, leading to liver enlargement, ascites, and liver dysfunction.
• Primary Biliary Cholangitis (PBC): An autoimmune disease of the liver characterized by a progressive destruction of the bile ducts within the liver, leading to cholestasis and, ultimately, liver cirrhosis.
• Primary Sclerosing Cholangitis (PSC): A chronic liver disease characterized by inflammation and scarring of the bile ducts inside and outside the liver, leading to cholestasis and potential liver failure.