ELEVATED LIVER ENZYMES

Elevated Liver EnzymesSevereALT > 15x ULNModerateALT 5-15x ULNMildALT < 5x ULNUS - Normal Bile DuctsUS - Dilated Bile DuctsHepatocellularALT or AST > ALPCholestatic (does not always cause Jaundice) ALP > ALT or AST Viral Drugs AIH Wilson's Hemochromatosis NAFLD Others Viral Drugs/ToxinsIschemia Autoimmune Wilson'sPregnancy AFLP HELLP Common Bile Duct Stone Biliary stricture PSC Worms/flukes Cholangiocarcinoma Pancreatic cancer Others NAFLD Alcohol Viral Hemochromatosis Drugs AIH A1AT deficiency Wilson's Others Cholestatic disease80Dx ALF if?INR and hepatic encephalopathy PBC PSC Alcoholic hepatitis Drugs TPN Sepsis Infiltrative Sarcoid Amyloid Malignancy Infection Cirrhosis (any)ETOH hepatitis usually cholestatic, and usually ALT < 300 NAFLD 10% population Dx by biopsy ± MRI/MRCPERCP for dxand therapy