In this case control study from the Acute Liver Failure Study Group registry, researchers determined that the combination of 3 simple lab tests diagnosed Wilson’s disease as a cause of acute liver failure with a sensitivity and specificity of 100%. These included AST:ALT ratio >2.2, alkaline phosphatase:total bilirubin ratio <4, and ceruloplasmin <20 mg/dL. Although this combination needs to be validated prospectively, this is an easy way to narrow the differential in patients presenting with acute liver failure (abstract)
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