DERANGED LIVER FUNCTION

infection:

any severe acute or chronic extra-hepatic infection (mild derangement in liver function, normal bilirubin)

liver abscess

acute hepatitis (A, B, C, etc.)

chronic viral hepatitis (B or C)

malignancy:

hepatocellular carcinoma (hepatoma)

cholangiocarcinoma

liver metastases

biliary disease:

cholelithiasis

ascending cholangitis

sclerosing cholangitis

acquired intrinsic liver disease:

autoimmune hepatitis

primary biliary cirrhosis

primary sclerosing cholangitis

cirrhosis from any cause

genetic / hereditary liver disease:

haemochromatosis

Wilson’s disease

alpha-1 antitrypsin deficiency

Crigler-Najjar disease (type 2 usually causes raised bilirubin only, 80-300 umol/l)

Gilbert’s syndrome (slightly raised bilirubin only, usually <80umol/l)

drugs:

idiosynchratic reaction (cholestatic and/or hepatitic picture)

known hepatotoxic drugs (e.g. paracetamol overdose, methotrexate, most anti-TB drugs)

toxins / poisons:

carbon tetrachloride

mushroom poisoning

other / miscellaneous:

autoimmune disease (e.g. SLE)

alcohol (including chronic abuse, alcoholic hepatitis, cirrhosis)

any large benign focal liver lesion (e.g. hydatid cyst, haemangioma)

liver trauma

ischaemic hepatopathy