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diagnosis differential injury causes transaminitis acute chemistry drug druginduced elevated gastroenterology hepatocellular hepatomegaly idiosyncratic induced interpretation liverenzymes management rvalue transaminases
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Chronic - ongoing ↑ LFTs ... or symptoms of liver ... disease 6-9 mo ... gastroenterology #algorithm ... gastroenterology #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... disease, Hepatic ... steatosis • Autoimmune ... hepatitis #DILI ... #hepatology
Elevated Transaminases / Transaminitis - Differential Diagnosis • Infectious: HAV, HCV, HEV, EBV, HSV, CMV •
Trauma: Shock liver ... Metabolic: Wilson Disease ... obstruction syndrome • Autoimmune ... : DILI, Tylenol, ... Diagnosis #causes #hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Differential Diagnosis Algorithm ... • Autoimmune: ... Autoimmune hepatitis ... • Iatrogenic: DILI ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
• Infections: Hepatitis ... Other: NAFLD, Autoimmune ... Differential #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... • Ischemia • Autoimmune ... • Cholestatic disease ... • Alcoholic hepatitis ... • Others #LFTs
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... Non-Malignant • Fatty Liver ... Hemochromatosis • Wilson's Disease ... • Autoimmune ... #Causes #Hepatology
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Other: NAFLD, Autoimmune ... Syndrome, Celiac Disease ... , Infiltrative Disease ... Causes #Acute #algorithm ... #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... of cholestatic disease ... disease: > 2 ... #differential #Hepatology ... transaminitis #LFTs
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