DIFFERENTIAL DIAGNOSIS

https://www.hepvic.org.au/news/2224/hot-news-resources-for-your-liver-and-your-health

 

 

Autoimmune Hepatitis

• • Chronic, progressive, autoimmune disease of the liver
  • Unknown cause; thought to be activated by environmental trigger- infections, medications, vaccines, viruses
  • Auto-reactive T-cells recognize an antigen and stimulate the secretion of cytokines inducing inflammation
  • WHY:
    • More common in women & children
    • S/SX of P.A.: jaundice, fatigue, weight loss

1. • WHY NOT:
     • S/SX affiliated with autoimmune hepatitis: many different presentations- usually asymptomatic, but can be moderate-severe mirroring cirrhosis or liver failure. Typically accompanied by joint pain due to antigen-antibody complexes (Heneghan, 2019).
     • SOCIAL HX: IVDU
     • *diagnosed by exclusion of other diseases & labs (increased IgG)

https://verywellhealth.com/autoimmune-diseases-overview-3232654

(McCance & Huether, 2019)

 

Cirrhosis

• • Fibrotic, inflammatory liver disease; irreversible
  • Caused by other disorders (alcoholism, viral, fatty liver disease, toxins)
  • Cellular injury leads to structural and fibrotic changes via inflammatory response and Kupffer cell activation
  • Extensive fibrosis obstructs/shunts blood flow and biliary channels causing hypoxia and necrosis
  • WHY:
    • S/SX of P.A.: jaundice, fatigue, weight loss, RUQ pain, prolonged bleeding
  • WHY NOT:
    • S/SX affiliated with cirrhosis: asymptomatic or progression of disease- ascites, portal hypertension, hepatic encephalopathy, esophageal varices with GI bleeding, palmar erythema, spider angiomata
    • *diagnosed by physical exam & biopsy

(McCance & Huether, 2019)

https://depositphotos.com/248659500/stock-illustration-vector-poster-liver-cirrhosis-symptoms.html

 

 

Liver Cancer- Hepatocellular Carcinoma (HCC)

• • Commonly a result of cirrhosis, chronic hepatitis B/C due to increased hepatocyte proliferation, epigenetic modifications (carcinogenesis)
  • WHY:
    • S/SX of P.A.: vague or dull RUQ abdominal pain, jaundice, lack of appetite, prolonged bleeding

• • WHY NOT:
    • S/SX affiliated with HCC: portal hypertension, ascites, GI bleeding
    • *diagnosed by physical exam, s/sx, labs, imaging (US)- no biopsy!

(McCance & Huether, 2019)