Causes of tender hepatomegaly

Acute hepatitis

• Infection (eg, hepatitis A virus, hepatitis E virus, bacterial, parasitic)
• Drug-induced liver injury
• Alcoholic hepatitis

Impaired venous outflow

• Budd-Chiari syndrome
• Right heart failure
• Hepatic sinusoidal obstruction syndrome (SOS)
• Peliosis hepatis

Causes of nontender hepatomegaly

Cholestatic liver disease

• Primary biliary cholangitis (PBC)
• Primary sclerosing cholangitis (PSC)

Storage disorders

• Disorders of lipid metabolism
  • alcohol-associated fatty liver disease
  • nonalcoholic fatty liver disease
  • diabetes mellitus
  • Lysosomal acid lipase deficiency
• Disorders of glycogen metabolism, see Glycogen storage diseases
• Gaucher disease, see Lysosomal Storage Diseases
• Alpha-1 antitrypsin deficiency (AAT)
• Hereditary hemochromatosis
• Wilson disease

Infiltrative diseases

• Granulomatous disease
  • infection (eg, tuberculosis)
  • autoimmune conditions (eg, sarcoidosis)
  • drug-induced liver injury
• Hepatic amyloidosis
• Hepatosplenic T cell lymphoma
• Malignant tumors
  • hepatocellular carcinoma
  • cholangiocarcinoma
• Benign lesions