Differential Diagnosis for 30 yo M with Elevated LFT's and Scleral Icterus
Single Most Likely Diagnosis
- Viral Hepatitis: This is a common cause of elevated liver function tests (LFTs) and scleral icterus in a young adult. Hepatitis A, B, and C are all possible, but hepatitis B is more likely to cause acute symptoms.
Other Likely Diagnoses
- Alcoholic Liver Disease: Although the patient is young, alcohol abuse can start early and lead to liver damage. A history of excessive alcohol consumption would support this diagnosis.
- Drug-Induced Liver Injury: Many medications and supplements can cause liver damage, so a thorough medication history is essential.
- Autoimmune Hepatitis: This is an autoimmune disease that can cause liver inflammation and damage. It is more common in women, but can occur in men.
- Wilson's Disease: This is a genetic disorder that causes copper accumulation in the liver, leading to liver damage. It is rare, but should be considered in young adults with unexplained liver disease.
Do Not Miss Diagnoses
- Budd-Chiari Syndrome: This is a rare condition where the hepatic veins are blocked, leading to liver congestion and damage. It can be life-threatening if not treated promptly.
- Acute Biliary Obstruction: This can cause severe liver damage and even death if not treated quickly. A history of gallstones or other biliary disease would increase the suspicion for this diagnosis.
- Hemochromatosis: This is a genetic disorder that causes iron accumulation in the liver, leading to liver damage. It is more common in men and can be life-threatening if not treated.
Rare Diagnoses
- Primary Biliary Cholangitis: This is an autoimmune disease that causes bile duct damage and liver inflammation. It is more common in women and typically presents with pruritus and fatigue.
- Primary Sclerosing Cholangitis: This is a rare disease that causes bile duct scarring and liver damage. It is often associated with inflammatory bowel disease.
- Alpha-1 Antitrypsin Deficiency: This is a genetic disorder that causes liver damage and lung disease. It is rare, but should be considered in young adults with unexplained liver disease.