Published on
​Symptoms and Signs – Differential Diagnosis of  Hepatitis C
• Autoimmune hepatitis
• Brucellosis
• Cytomegalovirus (CMV) infection
• Drug-induced liver disease
• Herpes simplex virus infection
• Infectious mononucleosis
• Ischemic hepatitis
• Leptospirosis
• Other hepatitis virus (A, B, D, E)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Hepatitis D
• Autoimmune hepatitis
• Brucellosis
• Cytomegalovirus (CMV) infection
• Drug-induced liver disease
• Herpes simplex virus infection
• Infectious mononucleosis
• Ischemic hepatitis
• Leptospirosis
• Other hepatitis virus (A, B, C, E)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Hepatitis E
• Autoimmune hepatitis
• Brucellosis
• Cytomegalovirus (CMV) infection
• Drug-induced liver disease
• Herpes simplex virus infection
• Infectious mononucleosis
• Ischemic hepatitis
• Leptospirosis
• Other hepatitis virus (A, B, C, D)
Picture
Published on
Symptoms and Signs - ​Differential Diagnosis of Hepatomegaly
• Alcoholic fatty infiltration
• Alcoholic hepatitis
• Amyloidosis
• Biliary cirrhosis
• Budd-Chiari syndrome
• Carcinoma: liver, pancreas, bile ducts, metastatic neoplasm to liver
• Cholangitis
• Cirrhosis
• Congestive heart failure (CHF)
• Familial hyperlipoproteinemia type I
• Hemochromatosis with cirrhosis
• Infectious hepatitis
• Infectious mononucleosis
• Leukemia
• Liver abscess
• Lymphoma
• Myelofibrosis with myeloid metaplasia
• Nonalcoholic steatohepatitis
• Obstruction of common bile duct
• Other: amebiasis, hydatid disease of liver, schistosomiasis, kalaazar (Leishmania donovani), Hurler’s syndrome, Gaucher’s disease, kwashiorkor
• Sarcoidosis
• Toxic hepatitis
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Hepatomegaly, by Shape of Liver
DIFFUSELY ENLARGED AND SMOOTH
Massive
• Metastatic disease
• Alcoholic liver disease with fatty infiltration
• Myeloproliferative diseases (e.g., polycythemia rubra vera,
myelofibrosis)
Moderate
• The above causes
• Hemochromatosis
• Hematologic disease (e.g., chronic myeloid leukemia, lymphoma)
• Fatty liver (e.g., diabetes mellitus, obesity)
• Infiltrative disorders (e.g., amyloid)
Mild
• The above causes
• Hepatitis (viral, drugs)
• Cirrhosis
• Biliary obstruction
• Granulomatous disorders (e.g., sarcoid)
• HIV infection
DIFFUSELY ENLARGED AND IRREGULAR
• Metastatic disease
• Cirrhosis
• Hydatid disease
• Polycystic liver disease
LOCALIZED SWELLINGS
• Riedel’s lobe (a normal variant; the lobe may be palpable in the
right lumbar region)
• Metastasis
• Large simple hepatic cyst
• Hydatid cyst
• Hepatoma
• Liver abscess (e.g., amebic abscess)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Hepatic Granulomas
• Bacterial, spirochetal: TB and atypical mycobacterial infections, tularemia, brucellosis, leprosy, syphilis, Whipple’s disease, listeriosis
• Beryllium, parenteral foreign material (e.g., starch, talc, methyldopa, procainamide, allopurinol, α-silicone), phenylbutazone, phenytoin, nitrofurantoin, hydralazine
• Fungal: coccidioidomycosis, histoplasmosis, cryptococcal infections, actinomycosis, aspergillosis, nocardiosis
• Parasitic: schistosomiasis, clonorchiasis, toxocariasis, ascariasis, toxoplasmosis, amebiasis
• Primary biliary cirrhosis, granulomatous hepatitis, jejunoileal bypass
• Rickettsial: Q fever
• Sarcoidosis, Wegener’s granulomatosis, inflammatory bowel disease, Hodgkin’s disease, lymphoma
• Viral: mononucleosis, cytomegalovirus (CMV)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Acute Hepatitis 
• Acute Budd-Chiari syndrome
• Acute fatty liver of pregnancy
• Autoimmune
• Brucellosis
• Cytomegalovirus
• Drug induced
• Epstein-Barr virus
• Hepatitis A, B, C, D, G
• Herpes simplex virus
• HIV infection
• Ischemic
• Leptospirosis
• Lyme disease
• Q fever
• Syphilis
• Wilson’s disease
• Yellow fever
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Hepatitis, Autoimmune
• Acute viral hepatitis (A, B, C, D, E; cytomegalovirus [CMV], Epstein-Barr virus, herpes)
• Chronic viral hepatitis (B, C)
• Hemochromatosis
• Nonalcoholic steatohepatitis
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Systemic lupus erythematosus (SLE)
• Toxic hepatitis (alcohol, drugs)
• Wilson’s disease
• α1-Antitrypsin deficiency
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Chronic Hepatitis 
• Alcoholic liver disease
• Autoimmune hepatitis and variant syndromes
• Chronic viral hepatitis
• Drug induced
• Drug-induced liver disease
• Fatty liver and nonalcoholic steatohepatitis
• Hepatic granulomas
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Hereditary hemochromatosis
• Idiopathic
• Infectious
• Neoplastic
• Wilson’s disease
• α1-Antitrypsin deficiency
Picture