Following are differential diagnoses for patients presented with elevated ALT.
- Hepatocyte damage
- Hypoxia (eg, anemia, cardiopulmonary disease, thromboembolic disease, seizures, ischemic myopathy [cats])
- Portosystemic shunt
- Portal vein hypoplasia
- Hepatic lipidosis (cats)
- Diabetes mellitus
- Hyperthyroidism
- Hyperadrenocorticism (usually only mild to moderate elevation, less common than ALP elevation)
- Neoplasia
- Inflammatory (eg, copper storage disease, chronic hepatitis)
- Infectious (eg, leptospirosis, bacterial cholangiohepatitis, FIP, histoplasmosis, canine infectious hepatitis [adenovirus type 1])
- Drugs (eg, acetaminophen, azathioprine, carprofen, tetracyclines, methimazole, trimethoprim–sulfonamides, amiodarone, chronic phenobarbital administration)
- Toxicity (eg, blue-green algae, Amanita spp mushrooms, aflatoxin, xylitol, sago palm, azole antifungals)
- Reactive hepatopathy (eg, enteritis, chronic enteropathy)
- Pancreatitis
- Trauma
- Muscular dystrophy (dogs)
- Induction (independent from toxicity)
- Phenobarbital
- Glucocorticoids
- Other
For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.
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