Differential Diagnosis for Raised ALT and AST in a 49-year-old Female
Single Most Likely Diagnosis
- Non-alcoholic fatty liver disease (NAFLD): This is a common condition in adults, often associated with obesity, diabetes, and metabolic syndrome, which can cause elevated liver enzymes.
Other Likely Diagnoses
- Alcoholic liver disease: A history of alcohol abuse can lead to liver damage and elevated liver enzymes.
- Viral hepatitis: Hepatitis B and C can cause chronic liver inflammation, leading to elevated ALT and AST levels.
- Drug-induced liver injury: Certain medications, such as statins, can cause liver enzyme elevations.
- Autoimmune hepatitis: A chronic autoimmune disease that causes liver inflammation and can lead to elevated liver enzymes.
Do Not Miss Diagnoses
- Acute liver failure: Although less common, conditions like acetaminophen overdose or viral hepatitis can cause rapid liver failure, which is life-threatening if not promptly treated.
- Wilson's disease: A rare genetic disorder that can cause liver damage and neurological symptoms, which can be fatal if not diagnosed and treated early.
- Budd-Chiari syndrome: A rare condition caused by thrombosis of the hepatic veins, which can lead to liver failure and is life-threatening if not promptly diagnosed and treated.
Rare Diagnoses
- Alpha-1 antitrypsin deficiency: A genetic disorder that can cause liver disease and lung disease.
- Hemochromatosis: A genetic disorder that causes iron overload, leading to liver damage and other systemic complications.
- Primary biliary cholangitis: A chronic autoimmune disease that causes progressive destruction of the bile ducts, leading to liver damage and cirrhosis.