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A 40-year-old asymptomatic Chinese-American man

40 years old | Male

Vignette:

A 40-year-old asymptomatic Chinese-American man presents for a routine visit with an elevated alanine aminotransferase level (55 IU/mL). His mother died of hepatocellular carcinoma and he has a middle-aged sister with hepatitis B infection. He has a normal physical exam and has no stigmata of chronic liver disease.

Summary:

elevated alanine aminotransferase | family history of hepatocellular carcinoma | family history hepatitis B

Dx:

Chronic Hepatitis Hepatitis Hepatitis B Acute Hepatitis Autoimmune hepatitis

Ref:

https://online.epocrates.com/diseases/12722/Hepatitis-B/Common-Vignette

Rank

Disease

Weight
1 Chronic Hepatitis 263.0
2 Autoimmune hepatitis 248.0
3 Common cutaneous drug reactions 140.0
4 Acute Liver Failure 116.0
5 Primary biliary cirrhosis 103.0
6 Biliary cirrhosis 103.0
7 Gallstone pancreatitis 100.0
8 Primary sclerosing cholangitis 87.0
9 Acute Cholangitis 84.0
10 chronic acalculous cholecystitis 83.0
11 Liver Cirrhosis 78.0
12 Acute Hepatitis 73.0
13 Acute fatty liver of pregnancy 69.0
14 Acute intermittent porphyria 68.0
15 Eclampsia 68.0
16 Infectious mononucleosis 66.0
17 Gallbladder Dyskinesia 65.0
18 Choledocholithiasis 65.0
19 Familial Mediterranean fever 62.0
20 Cholangiocarcinoma 61.0
21 Klebsiella pneumoniae liver abscess 59.0
22 Hepatocellular carcinoma 57.0
23 biliary SOD 55.0
24 Breast Cancer 50.0
25 Hemolytic uremic syndrome 50.0
26 Non-alcoholic Fatty Liver Disease 46.0
27 Wilson disease 46.0
28 Erythema nodosum 46.0
29 Polyarteritis nodosa 45.0
30 Hereditary hemochromatosis 44.0
31 Acetaminophen overdose 42.0
32 Alcoholic hepatitis 41.0
33 Alcoholic Fatty Liver 41.0
34 Alcoholic Liver Disease 41.0
35 Alcoholic Liver Cirrhosis 41.0
36 Autoimmune Pancreatitis 41.0
37 Systemic lupus erythematosus 41.0
38 Acute heart failure 39.0
39 Acalculous Cholecystitis 38.0
40 Food poisoning 35.0
41 Chronic Lymphocytic Leukemia 34.0
42 Brucellosis 34.0
43 Kawasaki disease 31.0
44 Cholestasis 30.0
45 Intrahepatic Cholestasis 30.0
46 Ovarian Hyperstimulation Syndrome 30.0
47 Preeclampsia 30.0
48 Sarcoidosis 30.0
49 Extraintestinal Entamoeba histolytica amebiasis 30.0
50 Acute Lymphocytic Leukemia in Adults 27.0
51 Hepatic Encephalopathy 26.0
52 Osteomalacia 26.0
53 chronic biliary obstruction 25.0
54 Glomerulonephritis 25.0
55 Autosomal Recessive Polycystic Kidney Disease 24.0
56 Non-small cell lung cancer 24.0
57 Mirizzi Syndrome 24.0
58 Hyperthyroidism 23.0
59 Graves Disease 23.0
60 Typhoid infection 23.0
61 Rocky Mountain spotted fever 23.0
62 Chronic liver disease 23.0
63 Epididymo-orchitis 21.0
64 pancreatic SOD 20.0
65 Pyogenic Liver Abscess 20.0
66 Amebic Liver Abscess 20.0
67 Malaria 20.0
68 Acute viral meningitis 20.0
69 Chronic atrial fibrillation 20.0
70 Toxic thyroid adenoma 20.0
71 Atypical pneumonia 20.0
72 Non-cholera Vibrio infections 20.0
73 Celiac Disease 18.0
74 Chronic Cholecystitis 18.0
75 Tuberculous Peritonitis 18.0
76 Cystic Fibrosis 18.0
77 Acute Myeloid Leukemia in children 18.0
78 Hyperprolactinemia 18.0
79 Gestational diabetes mellitus 18.0
80 Diabetic Ketoacidosis 18.0
81 Crohn Disease 17.0
82 Guillain-Barre syndrome 17.0
83 Chronic fatigue syndrome 17.0
84 Tinnitus 17.0
85 Ulcerative Colitis 16.0
86 Pulmonary Embolism 16.0
87 Acute Cholecystitis 15.0
88 Emphysematous cholecystitis 15.0
89 Graves ophthalmopathy 15.0
90 Peutz-Jeghers Syndrome 15.0
91 Psoas Abscess 15.0
92 Intrahepatic cholestasis of pregnancy 15.0
93 Extrahepatic Cholestasis 14.0
94 Psoriasis 14.0
95 Hyperosmolar Hyperglycemic state 14.0
96 Gallbladder cancer 14.0
97 Adrenocortical carcinoma 13.0
98 Osteoporosis 13.0
99 Amyloidosis 13.0
100 Hypothyroidism 12.0
101 Systemic sclerosis 12.0
102 Primary Myelofibrosis 12.0
103 Foodborne E coli infection 12.0
104 Clonorchiasis 12.0
105 Chronic Clonorchiasis 12.0
106 Campylobacter infection 12.0
107 Middle East respiratory syndrome 11.0
108 Deep venous thrombosis 11.0
109 Endometrial cancer 11.0
110 Gastritis 10.0
111 biliary obstruction 10.0
112 Splenic Rupture 9.0
113 Penis Carcinoma 9.0
114 Testicular cancer 9.0
115 Painless thyroiditis 9.0
116 Salmonella infection 9.0
117 Hepatorenal Syndrome 8.0
118 Renal and perinephric abscess 8.0
119 Central retinal artery occlusion 8.0
120 Familial adenomatous polyposis syndrome 8.0
121 Lung Cancer 8.0
122 Goiter 8.0
123 Diffuse nontoxic goiter 8.0
124 Toxic multinodular goiter 8.0
125 Obstructive cervical goiters 8.0
126 Cervical goiter 8.0
127 Renal Cell Carcinoma 7.0
128 Short bowel syndrome 7.0
129 Oropharyngeal cancer 7.0
130 Gallstones 6.0
131 Shigellosis 6.0
132 Granulomatosis with polyangiitis 6.0
133 Pneumonia 5.0
134 Inflammatory Bowel Diseases 4.0
135 Dermatophyte infections 4.0
136 Hereditary Angioedema 3.0
137 Hypogammaglobulinemia 3.0
138 Thyroid lymphoma 3.0
139 Anaplastic thyroid cancer 3.0
140 Budd Chiari Syndrome 2.0
141 Alopecia areata 1.0
142 Acute Clonorchiasis 0.0
143 Bell palsy 0.0
144 Immune thrombocytopenia 0.0
145 Phenylketonuria 0.0
146 Disseminated intravascular coagulation 0.0
147 Stevens-Johnson syndrome 0.0