Elevated cholestatic liver enzymes
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Revision as of 22:10, 10 July 2022 by Aidan (talk | contribs) (Created page with "== Background == * Refers to a rise in ALP and GGT +/- bilirubin that is much more pronounced than any rise in ALT == Differential Diagnosis == === Marked Elevation === * Extrhepatic biliary obstruction ** Choledocholithiasis ** Cancer of the pancreas, gallbladder, ampulla of Vater, biliary duct, or perihilar lymph nodes ** Biliary strictures *** Primary sclerosing cholangitis with extrahepatic bile duct stricture *** Procedural complica...")
Background
- Refers to a rise in ALP and GGT +/- bilirubin that is much more pronounced than any rise in ALT
Differential Diagnosis
Marked Elevation
- Extrhepatic biliary obstruction
- Choledocholithiasis
- Cancer of the pancreas, gallbladder, ampulla of Vater, biliary duct, or perihilar lymph nodes
- Biliary strictures
- Primary sclerosing cholangitis with extrahepatic bile duct stricture
- Procedural complication of ERCP
- Chronic pancreatitis resulting in stricture of the distal bile duct
- Anastomotic stricture of the bile duct after liver transplantation
- Infection: AIDS cholangiopathy, Ascaris lumbricoides, liver fluke
- Intrahepatic cholestasis
- Drugs and toxins
- Primary biliary cholangitis
- Primary sclerosing cholangitis
- Intrahepatic cholestasis of pregnancy
- Benign postoperative cholestasis
- Total parenteral nutrition
- Infiltrative diseases: amyloidosis, lymphoma, sarcoidosis, tuberculosis, or hepatic abscess
- Liver metastases
- Allograft rejection after liver transplant
- Alcoholic hepatitis
- Hepatic crisis of sickle cell disease
- Others: IgG4 cholangiopathy, ischemic cholangiopathy, COVID-19
