Disease | Tests and findings |
Alcoholic liver disease | History of alcohol abuse |
AST/ALT >2 with both being less than 500 international unit/mL if alcoholic hepatitis is present |
Chronic hepatitis C | ELISA assay for anti-HCV |
PCR for HCV RNA if confirmatory test is necessary |
Primary biliary cholangitis | Antimitochondrial antibodies as an isolated finding |
IgM elevation |
Primary sclerosing cholangitis | Strong association with inflammatory bowel disease |
Cholangiography to establish the diagnosis |
Antinuclear and antismooth muscle antibodies and ANCA; these are not diagnostic |
Autoimmune hepatitis | Hypergammaglobulinemia |
Antinuclear and smooth muscle antibodies and ANCA in type 1; anti-LKM-1 in type 2 |
Chronic hepatitis B | HBsAg and HBeAg and, in some cases, HBV DNA by hybridization or bDNA assay |
Hereditary hemochromatosis | Family history of cirrhosis |
Transferrin saturation and plasma ferritin should be performed but may be elevated by liver disease itself |
Diagnosis established by genetic testing or liver biopsy and calculation of hepatic iron index |
Wilson disease | Family or personal history of cirrhosis at a young age |
Serum ceruloplasmin reduced in 95 percent of patients |
Liver biopsy shows increased copper content, which may also be seen in cholestatic liver diseases |
Alpha-1 antitrypsin deficiency | Family or personal history of cirrhosis at a young age |
Serum AAT; phenotyping if low or borderline values |
Nonalcoholic fatty liver disease | History of diabetes mellitus or metabolic syndrome |
Diagnosis may be suspected by abnormal liver biochemical tests and hepatic imaging showing fatty infiltration and is confirmed by liver biopsy |
Congestive hepatopathy | History of right-sided heart failure, constrictive pericarditis, mitral stenosis, tricuspid regurgitation, cor pulmonale, cardiomyopathy |
Right upper quadrant ultrasonography with Doppler studies of the portal and hepatic veins and hepatic artery, electrocardiogram, and cardiac ultrasound |