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Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Diagnosis and Management ... Chronic - ongoing ↑ LFTs ... #differential #Diagnosis ... gastroenterology #algorithm ... gastroenterology #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Tests (LFTs) - ... Differential Diagnosis ... (>1000): • DILI ... Function #Tests #LFTs ... #hepatology #transaminitis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis ... Algorithm DILI ... non-essential drug/HDS treatments ... for alternative causes ... #Algorithm #hepatology
Evaluation abnormal liver tests in pregnancy
- Cholestatic Pattern
- Hepatocellular Pattern

#LFTs #transaminits #pregnancy #obgyn #obstetrics #hepatology #diagnosis
Evaluation abnormal liver ... Hepatocellular Pattern #LFTs ... obgyn #obstetrics #hepatology ... #diagnosis #differential ... #algorithm
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
- Vitals - LFTs ... GTT, indirect bili ... biopsy Meds: ... - Outpatient meds ... Calling #Referral #Hepatology
Liver Function Test (LFTs) Elevation
AST - Cardiac and skeletal muscle, kidney, brain
ALT - More specific for
(LFTs) Elevation ... abnormality vs bone Bili ... #FunctionTest #LFTs ... Transaminitis #diagnosis ... #hepatology
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury
Hepatocellular Liver Injury
 • AST/ALT elevation
Liver Enzymes (LFTs ... ) - Causes of Hepatocellular ... #Enzymes #LFTs ... Transaminitis #diagnosis ... #differential #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic Liver ... months without treatment ... Injury (DILI) ... Failure #Cirrhosis #Hepatology ... gastroenterology #management #diagnosis
Liver Mass - Differential Diagnosis Algorithm
Benign Cystic 
 • Cyst
 • Polycystic Liver Disease
 • Caroli's
Liver Mass - Differential ... Diagnosis Algorithm ... #Mass #Hepatology ... #Differential #Diagnosis ... #Algorithm #Causes
Elevated Transaminases / Transaminitis - Differential Diagnosis

 • Infectious: HAV, HCV, HEV, EBV, HSV, CMV
 •
- Differential Diagnosis ... Trauma: Shock liver ... • Iatrogenic: DILI ... #Differential #Diagnosis ... #causes #hepatology