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Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury Hepatocellular Liver Injury • AST/ALT elevation
Hepatocellular and Cholestatic ... Liver Injury ... Hepatocellular or Cholestatic ... R ≤ 2 = Cholestatic ... Hepatocellular #Cholestatic
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... poisoning, ETOH Cholestatic ... elevation Labs in Cholestatic ... epithelia: - Cholestasis ... ALT: typical of cholestatic
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
ALT ≥ 3x ULN Cholestatic ... Hepatocellular injury ... pattern ≤2: Cholestatic ... injury Sinai
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
RNA • R < 2: Cholestasis ... ALF): • Liver injury ... hepatocellular injury ... • Acute muscle injury ... Chronic muscle injury
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
of Acute Liver Injury ... Thrombus, Vasospasm Cholestatic ... Hepatitis, TB Cholestatic ... Sophia_Hayes_MD #Liver #Injury
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Drug-induced Liver Injury ... dose dependent injury ... Mixed DILI • Cholestatic ... induced #Liver #Injury
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
Hepatocellular Liver Injury ... Framework: Liver Injury ... phosphatase) 2) Cholestatic ... Hepatocellular Liver Injury ... Hepatocellular #Liver #Injury
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Induced Liver Injury ... involvement, Kidney injury ... titres, ↑ IgG • Cholestatic ... DrugInduced #Liver #Injury
Primary Biliary Cirrhosis - Pathophysiology Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish Epigentics Risk
T-cell mediated BEC injury ... biliary fibrosis - Cholestasis
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
pattern of liver injury ... , though cholestatic
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