Acute mild-to-moderate elevation in ALT AST

(<15× ULN)

• Assess risk of EtOH/drug/toxin: H&P; in EtOH AST:ALT ratio >2:1

• Obtain abdominal imaging to r/o cirrhosis, congestion, or biliary obstruction (mixed LFTs)

• Other infectious etiologies: tick borne illnesses, CMV/EBV, COVID-19, others

• Can be initial manifestation of chronic etiologies noted below