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diagnosis differential injury causes management saag transaminitis aclf albumin chemistry chronic dili druginduced failure gastroenterology gradient interpretation liverenzymes patterns rvalue
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... > 20x normal - Acute ... cirrhosis, Portal ... #Injury #hepatology ... #LFTs #transaminitis
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... months without treatment ... Failure Infections Alcohol-Associated ... Hepatitis (AAH) ... #Hepatology #gastroenterology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... hepatitis • Drugs ... Infiltrative • Cirrhosis ... • Others #LFTs ... #Hepatology #LiverEnzymes
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
- Cirrhosis ... - Alcoholic hepatitis ... fibrosis - Acute ... fatty liver of ... #differential #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
non-essential drug/HDS treatments ... HEV, EBV, CMV), Alcohol-related ... dechallenge • Acute ... disorder (e.g. ascites ... #hepatology
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
- Alcoholic hepatitis ... - Massive liver ... Veno-occlusive disease - Acute ... fatty liver of ... Differential #Diagnosis #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... ALT Ratios: • Alcoholic ... : < 1 • Cirrhosis ... #differential #Hepatology ... transaminitis #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Differential Diagnosis Algorithm ... ALT Ratios: • Alcoholic ... : < 1 • Cirrhosis ... #hepatology
Alcoholic Hepatitis - Management Algorithm Assess Eligibility for Treatment: - Maddrey Discriminant Function ≥ (or possibly MELD
Alcoholic Hepatitis ... - Management Algorithm ... blood, urine and ascites ... : - Acute kidney ... #Algorithm #hepatology
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