Differential Diagnosis for Increased Liver Enzymes
Single Most Likely Diagnosis
- Non-Alcoholic Fatty Liver Disease (NAFLD): This condition is increasingly common and can cause elevated liver enzymes without symptoms of liver disease. It is often associated with obesity, diabetes, and metabolic syndrome, making it a likely diagnosis in the absence of other clear causes.
Other Likely Diagnoses
- Alcoholic Liver Disease: Even without a reported history of alcohol abuse, liver disease due to alcohol can present with elevated liver enzymes. The absence of a hepatitis panel does not rule out alcoholic liver disease.
- Autoimmune Hepatitis: This condition can cause elevated liver enzymes and does not always present with a clear autoimmune panel. It is more common in women and can be associated with other autoimmune diseases.
- Hemochromatosis: A genetic disorder leading to iron overload, which can cause liver damage and elevated liver enzymes. It is more common in men and can be associated with other symptoms like arthritis and skin pigmentation.
Do Not Miss Diagnoses
- Wilson's Disease: A rare genetic disorder that leads to copper accumulation in the liver, causing damage. It is crucial to diagnose early as it can lead to severe liver disease and neurological symptoms if left untreated.
- Budd-Chiari Syndrome: A condition caused by thrombosis of the hepatic veins, leading to liver enlargement and elevated liver enzymes. It is a medical emergency and requires prompt diagnosis and treatment.
- Alpha-1 Antitrypsin Deficiency: A genetic disorder that can cause liver disease and elevated liver enzymes. It is essential to diagnose to provide appropriate management and genetic counseling.
Rare Diagnoses
- Primary Biliary Cholangitis (PBC): An autoimmune disease of the bile ducts that can cause elevated liver enzymes. It is more common in women and can be associated with other autoimmune diseases.
- Primary Sclerosing Cholangitis (PSC): A disease that causes scarring and narrowing of the bile ducts, leading to elevated liver enzymes. It is often associated with inflammatory bowel disease.
- Drug-Induced Liver Injury (DILI): Although the question specifies no statin use, other medications or supplements can cause liver injury, and a thorough medication history is essential to diagnose DILI.