A Liver Aetiological Screen investigates the cause for underlying liver disease, including:

• Viral hepatitis (if the blood test abnormality is chronic this should include hepatitis b and c, if the blood test abnormality is acute this should include hepatitis a and e)
• Autoimmune liver disease (measurements of AMA, SMA and ANA, as well as serum immunoglobulins)
• Haemochromatosis (measurement of serum ferritin and transferrin saturation)
• Alpha-1 antitrypsin deficiency (measurement of alpha-1 antitrypsin)
• Wilson’s disease (measurement of caeruloplasmin)

A liver ultrasound scan, while not part of a liver aetiological screen, should be performed at this stage as an important part of the diagnostic work-up to look for features of advanced liver disease such as splenomegaly.