Elevated Liver Enzymes
Mild
ALT < 5x ULN
Hepatocellular
ALT or AST > ALP
Cholestatic (does not always
cause jaundice) ALP > AST or ALT
NAFLD 10%
population
ERCP for dx and
therapy
ETOH hepatitis
usually cholestatic,
and usually ALT <
300
DX ALF if
↑INR and hepatic
encephalopathy
Viral
Drugs/Toxins
Ischemia
Autoimmune
Wilson’s
Pregnancy
AFLP
HELLP
US - Dilated Bile
Ducts
US Normal Bile
Ducts
Severe
ALT > 15x ULN
Moderate
AL