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diagnosis differential causes management transaminitis acute dili gastroenterology abnormal aclf chemistry chronic cirrhosis drug druginduced enzymes failure hepatocellular hepatomegaly idiosyncratic
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... Injury Transaminase ... #Patterns #Liver ... #Injury #hepatology ... #LFTs #transaminitis
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
Injury → liver ... Drugs (MDMA), Alcohol ... #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Injury - Differential ... HSV • Toxic: Alcohol ... #Injury #Differential ... Causes #Acute #algorithm ... #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... • Cholestatic disease ... hepatitis • Drugs ... • Others #LFTs ... #Hepatology #LiverEnzymes
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... Non-Malignant • Fatty Liver ... Hemochromatosis • Wilson's Disease ... Inflammatory • Alcoholic ... #Causes #Hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... ALT Ratios: • Alcoholic ... liver disease: ... #differential #Hepatology ... transaminitis #LFTs
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
disease, liver ... Failure Infections Alcohol-Associated ... Hepatitis (AAH) ... Injury (DILI) ... Failure #Cirrhosis #Hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... HEV, EBV, CMV), Alcohol-related ... liver disease, ... • Autoimmune hepatitis ... #Algorithm #hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... ALT Ratios: • Alcoholic ... liver disease: ... #injury #hepatitis ... #hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Injury (DILI) ... Chronic - ongoing ↑ LFTs ... disease 6-9 mo ... gastroenterology #algorithm ... gastroenterology #hepatology
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