42 years old | Male
A 42-year-old man is referred to the liver clinic with mild elevation in aminotransferases for several years. He has a medical history significant for obesity, hypertension, and hypercholesterolemia. He does not smoke or drink alcohol and there is no high-risk behavior. He has a family history of premature cardiac disease. He is taking a diuretic and, because of his elevated liver tests, was recommended to discontinue his statin medication several months ago. Other than complaints of mild fatigue, the patient feels well. Exam is notable for a BMI of 37 kg/m², truncal obesity, and mild hepatomegaly.
elevation in aminotransferases | obesity | hypertension | hypercholesterolemia | history of premature cardiac disease | taking a diuretic | fatigue | truncal obesity | hepatomegaly
Non-Alcoholic Fatty Liver Disease Hepatic steatosis
https://online.epocrates.com/diseases/79622/Hepatic-steatosis/Common-Vignette
Rank |
Disease |
Weight |
---|---|---|
1 | Primary biliary cirrhosis | 454.0 |
2 | Non-alcoholic Fatty Liver Disease | 414.0 |
3 | Stable ischemic heart disease | 408.0 |
4 | Adrenocortical carcinoma | 398.0 |
5 | Non-ST-elevation myocardial infarction | 361.0 |
6 | Biliary cirrhosis | 357.0 |
7 | Hepatocellular carcinoma | 354.0 |
8 | Eclampsia | 352.0 |
9 | Primary sclerosing cholangitis | 350.0 |
10 | Chronic atrial fibrillation | 345.0 |
11 | Obstructive Sleep Apnea | 345.0 |
12 | Liver Cirrhosis | 343.0 |
13 | Gout | 337.0 |
14 | Gallstone pancreatitis | 326.0 |
15 | ST-elevation myocardial infarction | 315.0 |
16 | Colorectal cancer | 311.0 |
17 | Preeclampsia | 305.0 |
18 | Erectile dysfunction | 302.0 |
19 | Cushing syndrome | 298.0 |
20 | Infectious mononucleosis | 288.0 |
21 | Type 2 Diabetes mellitus | 286.0 |
22 | Chronic heart failure | 284.0 |
23 | Kidney stones | 283.0 |
24 | Chronic Kidney Diseases | 281.0 |
25 | Hereditary hemochromatosis | 279.0 |
26 | Chronic Hepatitis | 275.0 |
27 | Hypertriglyceridemia | 265.0 |
28 | Achilles tendon rupture | 263.0 |
29 | Autoimmune hepatitis | 261.0 |
30 | Acute Pancreatitis | 260.0 |
31 | Abnormal uterine bleeding | 241.0 |
32 | Achilles tendinopathy | 238.0 |
33 | Pyogenic Liver Abscess | 232.0 |
34 | pancreatic cancer | 222.0 |
35 | Amebic Liver Abscess | 214.0 |
36 | Osteoarthritis | 214.0 |
37 | Migraine headache in adults | 213.0 |
38 | Endometrial cancer | 212.0 |
39 | Ischemic stroke | 212.0 |
40 | Diabetic Ketoacidosis | 211.0 |
41 | Papilledema | 207.0 |
42 | Thrombotic thrombocytopenic purpura | 205.0 |
43 | Klebsiella pneumoniae liver abscess | 203.0 |
44 | Rheumatoid Arthritis | 203.0 |
45 | Balanitis | 201.0 |
46 | Gallbladder cancer | 198.0 |
47 | Alcoholic hepatitis | 196.0 |
48 | Sarcoidosis | 196.0 |
49 | Deep venous thrombosis | 193.0 |
50 | Secondary hypogonadism | 191.0 |
51 | Alcoholic Fatty Liver | 190.0 |
52 | Diabetic Kidney Disease | 190.0 |
53 | Prinzmetal angina | 190.0 |
54 | Graves Disease | 189.0 |
55 | Acromegaly | 188.0 |
56 | Hepatic Encephalopathy | 183.0 |
57 | Varicose veins | 181.0 |
58 | Acute Liver Failure | 180.0 |
59 | Androgenetic alopecia | 180.0 |
60 | Hiatus hernia | 179.0 |
61 | Cellulitis | 179.0 |
62 | Choledocholithiasis | 178.0 |
63 | Systemic lupus erythematosus | 175.0 |
64 | Stroke | 171.0 |
65 | Renal Cell Carcinoma | 167.0 |
66 | Liver Abscess | 164.0 |
67 | Hypothyroidism | 163.0 |
68 | Aortic coarctation | 163.0 |
69 | Hemorrhagic stroke | 162.0 |
70 | Common cutaneous drug reactions | 161.0 |
71 | Gastroesophageal reflux disease | 161.0 |
72 | Primary hypogonadism | 161.0 |
73 | Multiple Myeloma | 161.0 |
74 | Autosomal Recessive Polycystic Kidney Disease | 160.0 |
75 | Malaria | 160.0 |
76 | Systemic sclerosis | 159.0 |
77 | Hemolytic uremic syndrome | 156.0 |
78 | Gallstones | 154.0 |
79 | Acute Lymphocytic Leukemia in Adults | 153.0 |
80 | Acute intermittent porphyria | 150.0 |
81 | Carpal Tunnel Syndrome | 150.0 |
82 | Polyarteritis nodosa | 150.0 |
83 | Acute Hepatitis | 149.0 |
84 | Analgesic nephropathy | 149.0 |
85 | Aortic Dissection | 149.0 |
86 | anterior ischemic optic neuropathy | 148.0 |
87 | Alzheimer disease | 148.0 |
88 | Acute Lymphoblastic leukemia in children | 148.0 |
89 | Glomerulonephritis | 147.0 |
90 | Pneumonia | 147.0 |
91 | Renal and perinephric abscess | 145.0 |
92 | Acute Cholecystitis | 144.0 |
93 | Celiac Disease | 143.0 |
94 | Breast Cancer | 140.0 |
95 | Osteomalacia | 139.0 |
96 | Alcoholic Liver Disease | 136.0 |
97 | Candidal intertrigo | 136.0 |
98 | Transient ischemic attack | 136.0 |
99 | Salmonella infection | 132.0 |
100 | Hyperaldosteronism | 131.0 |
101 | Clostridium difficile infection | 130.0 |
102 | Mitral Stenosis | 130.0 |
103 | Hepatorenal Syndrome | 129.0 |
104 | Hyperparathyroidism | 129.0 |
105 | Diabetes Mellitus | 128.0 |
106 | Chronic Pancreatitis | 128.0 |
107 | Amyloidosis | 127.0 |
108 | Emphysematous cholecystitis | 126.0 |
109 | Leiomyomas | 125.0 |
110 | Addison Disease | 125.0 |
111 | Multiple Sclerosis | 125.0 |
112 | Cholangiocarcinoma | 123.0 |
113 | Intrahepatic Cholestasis | 122.0 |
114 | Acne fulminans | 122.0 |
115 | Dermatophyte infections | 121.0 |
116 | Adrenal Suppression | 121.0 |
117 | Kawasaki disease | 119.0 |
118 | Budd Chiari Syndrome | 117.0 |
119 | Liver disease | 117.0 |
120 | Alcoholic Liver Cirrhosis | 115.0 |
121 | Psoriasis | 115.0 |
122 | Extraintestinal Entamoeba histolytica amebiasis | 114.0 |
123 | Aortic stenosis | 114.0 |
124 | Insomnia in adults | 113.0 |
125 | Granulomatosis with polyangiitis | 111.0 |
126 | Asthma | 110.0 |
127 | Anemia of chronic disease | 110.0 |
128 | Primary Myelofibrosis | 109.0 |
129 | Autosomal Dominant Polycystic Kidney Disease | 109.0 |
130 | Type 1 Diabetes mellitus | 108.0 |
131 | Brucellosis | 107.0 |
132 | Acute Myeloid Leukemia in adults | 107.0 |
133 | Stable angina | 107.0 |
134 | Menopause | 106.0 |
135 | Umbilical hernia | 106.0 |
136 | Hyperprolactinemia | 106.0 |
137 | Central retinal artery occlusion | 105.0 |
138 | Ankylosing spondylitis | 105.0 |
139 | Psoas Abscess | 104.0 |
140 | Cholestasis | 103.0 |
141 | Acute heart failure | 103.0 |
142 | Non-small cell lung cancer | 103.0 |
143 | End Stage Renal Disease | 103.0 |
144 | Hyperthyroidism | 102.0 |
145 | Wilson disease | 101.0 |
146 | Open Angle Glaucoma | 100.0 |
147 | Peyronie Disease | 100.0 |
148 | Familial Mediterranean fever | 99.0 |
149 | Food poisoning | 98.0 |
150 | Mesenteric ischemia | 98.0 |
151 | Ischemic optic neuropathy | 98.0 |
152 | posteriorischemic optic neuropathy | 98.0 |
153 | COPD Exacerbation | 98.0 |
154 | Autoimmune Pancreatitis | 97.0 |
155 | Crohn Disease | 97.0 |
156 | Acute fatty liver of pregnancy | 96.0 |
157 | Multiple endocrine neoplasia 2B | 96.0 |
158 | Tuberculous Peritonitis | 96.0 |
159 | Extrahepatic Cholestasis | 95.0 |
160 | Toxic multinodular goiter | 95.0 |
161 | Rocky Mountain spotted fever | 94.0 |
162 | Cataract | 94.0 |
163 | Renal Artery Stenosis | 94.0 |
164 | Chronic liver disease | 93.0 |
165 | Chronic Myeloid Leukemia | 92.0 |
166 | Chronic Mitral regurgitation | 91.0 |
167 | Painless thyroiditis | 90.0 |
168 | Hypercalcemia | 90.0 |
169 | Cystic Fibrosis | 89.0 |
170 | Multiple endocrine neoplasia 2A | 89.0 |
171 | Fibromyalgia | 88.0 |
172 | Graves ophthalmopathy | 87.0 |
173 | Goiter | 86.0 |
174 | Diffuse nontoxic goiter | 86.0 |
175 | Cervical goiter | 86.0 |
176 | Urinary Tract Obstruction | 86.0 |
177 | Obstructive cervical goiters | 83.0 |
178 | Hereditary Angioedema | 82.0 |
179 | Rotator Cuff Tears | 82.0 |
180 | Musculoskeletal lower back pain | 82.0 |
181 | Diabetic Neuropathy | 82.0 |
182 | Gestational diabetes mellitus | 78.0 |
183 | Osteoporosis | 78.0 |
184 | Atypical pneumonia | 78.0 |
185 | Acne conglobata | 78.0 |
186 | Gram-negative folliculitis | 78.0 |
187 | Excoriated acne | 78.0 |
188 | Heparin-induced thrombocytopenia | 78.0 |
189 | Intra-abdominal abscess | 78.0 |
190 | Gingivitis | 78.0 |
191 | Lung Cancer | 77.0 |
192 | Guillain-Barre syndrome | 76.0 |
193 | Secondary hyperparathyroidism | 76.0 |
194 | biliary SOD | 75.0 |
195 | Male factor infertility | 75.0 |
196 | Henoch-Schonlein purpura | 75.0 |
197 | Typhoid infection | 73.0 |
198 | Acute Myeloid Leukemia in children | 73.0 |
199 | Amphetamine use disorder | 73.0 |
200 | Non-diabetic hypoglycemia | 73.0 |
201 | Sialadenitis | 72.0 |
202 | Central hypothyroidism | 71.0 |
203 | Acute bacterial meningitis in neonates | 70.0 |
204 | Acute pyelonephritis in adults | 70.0 |
205 | Chronic Clonorchiasis | 69.0 |
206 | Ovarian and fallopian tube torsion | 69.0 |
207 | Bladder Cancer | 69.0 |
208 | Prolactinoma | 69.0 |
209 | Hyperosmolar Hyperglycemic state | 69.0 |
210 | chronic acalculous cholecystitis | 68.0 |
211 | Chronic Lymphocytic Leukemia | 68.0 |
212 | Acetaminophen overdose | 68.0 |
213 | Rosacea | 68.0 |
214 | Chronic pyelonephritis | 68.0 |
215 | Candida Balanitis | 68.0 |
216 | Oropharyngeal and esophageal candidiasis | 68.0 |
217 | Vulvovaginal candidiasis | 68.0 |
218 | Oral candidiasis | 68.0 |
219 | Premenstrual syndrome | 68.0 |
220 | Abetalipoproteinemia | 68.0 |
221 | Acute Clonorchiasis | 67.0 |
222 | Medullary thyroid cancer | 67.0 |
223 | Adrenal crisis | 67.0 |
224 | Osteomyelitis | 67.0 |
225 | Diabetic Amyotrophy | 66.0 |
226 | Spontaneous bacterial peritonitis | 66.0 |
227 | Influenza | 66.0 |
228 | Chronic fatigue syndrome | 65.0 |
229 | Labyrinthitis | 64.0 |
230 | Acute respiratory failure | 64.0 |
231 | Acute viral meningitis | 63.0 |
232 | Anaphylaxis | 63.0 |
233 | Ovarian Hyperstimulation Syndrome | 62.0 |
234 | Pheochromocytoma | 62.0 |
235 | Benign Prostatic Hyperplasia | 61.0 |
236 | Toxic thyroid adenoma | 60.0 |
237 | Gastroparesis | 60.0 |
238 | Shigellosis | 60.0 |
239 | Hypoparathyroidism | 59.0 |
240 | Acne vulgaris | 58.0 |
241 | Pancreatic Pseudocyst | 58.0 |
242 | Intestinal Obstruction | 58.0 |
243 | Viral pharyngitis | 58.0 |
244 | Ulcerative Colitis | 56.0 |
245 | Acalculous Cholecystitis | 56.0 |
246 | Chronic bacterial prostatitis | 56.0 |
247 | Familial adenomatous polyposis syndrome | 55.0 |
248 | Unstable angina | 55.0 |
249 | Churg-Strauss Syndrome | 54.0 |
250 | Cryptococcosis | 54.0 |
251 | Insect bites and stings | 53.0 |
252 | Migraine | 53.0 |
253 | Short bowel syndrome | 52.0 |
254 | Gilbert syndrome | 51.0 |
255 | Gallbladder Dyskinesia | 50.0 |
256 | Bell palsy | 50.0 |
257 | Priapism | 50.0 |
258 | Dry eye | 50.0 |
259 | Animal bites | 50.0 |
260 | Autoimmune hemolytic anemia | 50.0 |
261 | Pharyngitis | 50.0 |
262 | Bacterial pharyngitis | 50.0 |
263 | STI HIV Pharyngitis | 50.0 |
264 | Herpes pharyngitis | 50.0 |
265 | Acute Rhinosinusitis | 50.0 |
266 | Chronic pelvic pain in women | 50.0 |
267 | Acute viral rhinosinusitis | 50.0 |
268 | Acute bacterial rhinosinusitis | 50.0 |
269 | Acute bacterial meningitis in adults | 49.0 |
270 | Milk-alkali syndrome | 48.0 |
271 | Acute Milk-alkali syndrome | 48.0 |
272 | Pulmonary Embolism | 46.0 |
273 | Xanthelasma | 46.0 |
274 | Parkinson disease | 46.0 |
275 | Peutz-Jeghers Syndrome | 45.0 |
276 | Discogenic low back pain | 45.0 |
277 | Acute bacterial meningitis in children | 45.0 |
278 | cholestatic liver disease | 45.0 |
279 | Toxic Megacolon | 45.0 |
280 | Simple kidney cyst | 44.0 |
281 | Acute pericarditis | 44.0 |
282 | Psychogenic polydipsia | 43.0 |
283 | chronic biliary obstruction | 42.0 |
284 | Acute disseminated encephalomyelitis | 42.0 |
285 | Intrahepatic cholestasis of pregnancy | 41.0 |
286 | Foodborne E coli infection | 41.0 |
287 | COVID19 | 41.0 |
288 | Cholera | 41.0 |
289 | Ovarian Cancer | 41.0 |
290 | Primary ciliary dyskinesia | 41.0 |
291 | Allergic rhinitis | 41.0 |
292 | Kartagener syndrome | 41.0 |
293 | Annular pancreas | 40.0 |
294 | Tetanus | 40.0 |
295 | Pseudohypoparathyroidism | 39.0 |
296 | Campylobacter infection | 38.0 |
297 | Ascites | 37.0 |
298 | Mirizzi Syndrome | 36.0 |
299 | Clonorchiasis | 35.0 |
300 | Acute Cholangitis | 35.0 |
301 | Anaplastic thyroid cancer | 35.0 |
302 | pancreatic SOD | 34.0 |
303 | Systemic vasculitis | 34.0 |
304 | Candidiasis | 34.0 |
305 | Acute Mitral regurgitation | 34.0 |
306 | Giardiasis | 34.0 |
307 | Nasal polyps | 34.0 |
308 | Inflammatory Bowel Diseases | 33.0 |
309 | Musculoskeletal sprains and strains | 33.0 |
310 | chronic cholestatic liver disease | 33.0 |
311 | Acute atrial fibrillation | 32.0 |
312 | Acute Bacterial Prostatitis | 32.0 |
313 | Bullous pemphigoid | 32.0 |
314 | Barrett esophagus | 30.0 |
315 | Fibrocystic breasts | 30.0 |
316 | Tinea versicolor | 30.0 |
317 | Testicular cancer | 29.0 |
318 | Achalasia | 29.0 |
319 | Chronic Milk-alkali syndrome | 28.0 |
320 | Sunburn | 28.0 |
321 | Hypogammaglobulinemia | 26.0 |
322 | Drowning | 26.0 |
323 | Intussusception | 26.0 |
324 | Gastrointestinal Hemorrhage | 26.0 |
325 | Lower gastrointestinal hemorrhage | 26.0 |
326 | Upper gastrointestinal hemorrhage | 26.0 |
327 | Aseptic meningitis | 26.0 |
328 | Chronic Renal vein thrombosis | 25.0 |
329 | Herpes zoster | 25.0 |
330 | Gastritis | 23.0 |
331 | Substernal goiter | 23.0 |
332 | Common cold(adults) | 23.0 |
333 | Tinnitus | 23.0 |
334 | Subdural hematoma | 23.0 |
335 | Gastric cancer | 23.0 |
336 | Rotor syndrome | 23.0 |
337 | Irritable Bowel Syndrome | 23.0 |
338 | Esophagitis | 21.0 |
339 | Gallbladder Empyema | 21.0 |
340 | Stevens-Johnson syndrome | 20.0 |
341 | Intestinal Pseudo Obstruction | 20.0 |
342 | Fungal meningitis | 20.0 |
343 | Endometritis | 20.0 |
344 | Empyema | 20.0 |
345 | Genital herpes | 20.0 |
346 | Charcot-Marie-Tooth Disease | 20.0 |
347 | Travelers diarrhea | 20.0 |
348 | Intestinal Entamoeba histolytica amebiasis | 20.0 |
349 | Ruptured ectopic pregnancy | 20.0 |
350 | Viral Gastroenteritis | 19.0 |
351 | Chronic Cholecystitis | 18.0 |
352 | Uveitis | 18.0 |
353 | Anterior uveitis | 18.0 |
354 | Intermediate uveitis | 18.0 |
355 | Posterior uveitis | 18.0 |
356 | Pan uveitis | 18.0 |
357 | Acute cervical spine trauma | 18.0 |
358 | Lactose intolerance | 18.0 |
359 | Croup | 18.0 |
360 | mucosal Eosinophilic gastroenteritis | 17.0 |
361 | Muscle Layer Eosinophilic gastroenteritis | 17.0 |
362 | Acute peptic ulcer | 17.0 |
363 | Duodenal Ulcer | 17.0 |
364 | Gastric Ulcer | 17.0 |
365 | Chlamydia pneumoniae infection | 16.0 |
366 | Motion Sickness | 16.0 |
367 | Periorbital and orbital cellulitis | 16.0 |
368 | Ichthyosis | 15.0 |
369 | Pressure ulcer | 15.0 |
370 | Splenic abscess | 15.0 |
371 | Acute Appendicitis | 15.0 |
372 | Acute perforated appendicitis | 15.0 |
373 | Hemorrhoids | 15.0 |
374 | Bacterial conjunctivitis | 15.0 |
375 | Viral conjunctivitis | 15.0 |
376 | Mallory-Weiss syndrome | 15.0 |
377 | Dystonia | 15.0 |
378 | biliary obstruction | 14.0 |
379 | Secondary Peritonitis | 14.0 |
380 | Abdominal compartment syndrome | 14.0 |
381 | Bacterial gastroenteritis | 14.0 |
382 | Ruptured Tuboovarian abscess | 14.0 |
383 | Acute otitis media | 14.0 |
384 | Nephrogenic diabetes insipidus | 14.0 |
385 | Central diabetes insipidus | 14.0 |
386 | Laryngeal Cancer | 14.0 |
387 | Thyroid lymphoma | 13.0 |
388 | Peritoneal dialysis associated peritonitis | 13.0 |
389 | Angiodysplasia of the colon | 13.0 |
390 | Atopic dermatitis | 13.0 |
391 | Portal hypertension | 12.0 |
392 | Acute peritonitis | 12.0 |
393 | subserosal eosinophilic gastroenteritis | 12.0 |
394 | Diverticulitis | 12.0 |
395 | Oropharyngeal cancer | 11.0 |
396 | Psoriatic arthritis | 11.0 |
397 | Paraneoplastic Syndromes | 11.0 |
398 | Acute epididymitis | 11.0 |
399 | Mitral Valve Prolapse | 11.0 |
400 | Endometriosis | 10.0 |
401 | Listerial gastroenteritis | 10.0 |
402 | Dubin-Johnson syndrome | 10.0 |
403 | Acute Bronchitis | 9.0 |
404 | Acute Renal vein thrombosis | 9.0 |
405 | Zollinger-Ellison Syndrome | 9.0 |
406 | Anthrax | 9.0 |
407 | Non-cholera Vibrio infections | 8.0 |
408 | Eosinophilic gastroenteritis | 8.0 |
409 | Miliaria | 8.0 |
410 | Pelvic inflammatory disease | 8.0 |
411 | Acute pelvic inflammatory disease | 8.0 |
412 | Acute Cystitis(Men) | 7.0 |
413 | Cystitis | 7.0 |
414 | Urinary tract infection | 7.0 |
415 | Acute Cystitis(Women) | 7.0 |
416 | Splenic Rupture | 6.0 |
417 | Common cold(children) | 6.0 |
418 | Bed bugs | 5.0 |
419 | Pyelonephritis | 5.0 |
420 | Pityriasis rosea | 5.0 |
421 | Malt lymphoma | 3.0 |
422 | Penis Carcinoma | 1.0 |
423 | Alopecia areata | 1.0 |
424 | Phenylketonuria | 0.0 |
425 | Immune thrombocytopenia | 0.0 |
426 | Disseminated intravascular coagulation | 0.0 |
427 | Narcolepsy | 0.0 |
428 | Panic disorder in adults | 0.0 |
429 | Orthostatic hypotension | 0.0 |
430 | Optic neuritis | 0.0 |
431 | Neuropapillitis | 0.0 |
432 | Pulmonary regurgitation | 0.0 |
433 | Hodgkin lymphoma | 0.0 |