Differential Diagnosis for Low Albumin and High AST/ALT
- Single most likely diagnosis:
- Cirrhosis: This condition often leads to low albumin levels due to decreased liver synthesis and high AST/ALT levels due to liver cell injury.
- Other Likely diagnoses:
- NASH (Non-Alcoholic Steatohepatitis): Characterized by inflammation and fat accumulation in liver cells, leading to elevated liver enzymes and potentially decreased albumin production.
- Alcoholic Hepatitis: Direct liver damage from alcohol can cause both elevated liver enzymes and decreased albumin levels.
- Viral Hepatitis: Acute or chronic infections (e.g., hepatitis B or C) can lead to liver inflammation, elevated AST/ALT, and decreased albumin production.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Budd-Chiari Syndrome: A rare condition involving hepatic vein thrombosis, which can lead to liver dysfunction, including elevated liver enzymes and low albumin, and is potentially life-threatening if not promptly diagnosed and treated.
- Wilson's Disease: A genetic disorder leading to copper accumulation in the liver, causing liver damage, elevated liver enzymes, and potentially low albumin levels. It's crucial to diagnose early to prevent irreversible liver damage.
- Rare diagnoses:
- Alpha-1 Antitrypsin Deficiency: A genetic disorder that can cause liver disease, leading to elevated liver enzymes and potentially low albumin levels.
- Autoimmune Hepatitis: A condition where the body's immune system attacks liver cells, leading to inflammation, elevated liver enzymes, and potentially decreased albumin production.