Patterns of LFTs

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LFTs異常的四大類DDx

  • hepatocellular
    • 上升的ALT, aspartate aminotransferase,其他的不一定
  • Cholestatic
  • Infiltrative
  • Nonhepatic

hepatocellular 想四個DDx

  • Viral hepatitis, non-alcoholic fatty liver disease
    • 一般來說會是ALT>AST
  • Alchololic hepatitis
    • AST>2*ALT
  • Ischemic injury
    • 四項都高,因此shock liver的診斷還是把四項都抽一抽
  • Wilson Disease
    • Aφ : Tbili < 4 (if fulminat)

Cholestatic

Infiltrative

  • 反而是Aφ, Bilirubin高

Nonhepatic

  • Skeletal muscle injury
  • Bone Disease
  • Hemolysis