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diagnosis differential lfts transaminitis hepatitisb treatment aclf acute chemistry common dili druginduced failure function gastroenterology hematology hepatocellular hepbv hypogammaglobulinemia immunodeficiency
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... normal - Infection (EBV ... CMV), Alcoholic cirrhosis ... 5-10x normal - Chronic ... #Injury #hepatology
Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with
Chronic Hepatitis ... viremia or have cirrhosis ... Chronic Hepatitis ... #HepatitisB #HBV ... #Hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... Hepatic ischaemia ... e.g. ascites), Chronic ... hepatitis fibrosis ... #Algorithm #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
• NAFLD • Cirrhosis ... • Chronic Viral ... Hepatitis Moderate ... injury) • Ischemic ... Differential #Diagnosis #hepatology
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... injury (INR > 2 ... mg/dL) or acute liver ... #Indications #management ... #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... Injury (DILI) ... Viral Hepatitis ... #Cirrhosis #Hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Differential Diagnosis Algorithm ... : < 1 • Cirrhosis ... #injury #hepatitis ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
Injury → liver ... • Vascular: Ischemic ... #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
serologies, HCV ... > 2 • NASH, Chronic ... : < 1 • Cirrhosis ... : > 3 • Chronic ... #differential #Hepatology
Common Variable Immunodeficiency (CVID) What? CVID: Immunodeficiency disorder with hypogammaglobulinemia -> increased infection risk secondary to impaired B-cell
Autoimmunity • Chronic ... disease • Liver ... diseases and hepatitis ... Malignancies • Chronic ... #diagnosis #management
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