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diagnosis differential injury transaminitis acute chemistry druginduced elevated hepatocellular interpretation liverenzymes management patterns rvalue transaminases
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
for alternative causes ... , HBV, HCV, HEV, ... EBV, CMV), Alcohol-related ... Hepatic ischaemia ... #hepatology
Elevated Transaminases / Transaminitis - Differential Diagnosis • Infectious: HAV, HCV, HEV, EBV, HSV, CMV •
Trauma: Shock liver ... • Iatrogenic: DILI ... See Updated Schema ... Differential #Diagnosis #causes ... #hepatology
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... normal - Infection (EBV ... /CMV), Alcoholic ... #Injury #hepatology ... #LFTs #transaminitis
Clinical diagnosis of Alcoholic Hepatitis (AH) • Onset of jaundice within prior 8 weeks • Ongoing
Hepatitis (AH) ... factors • Possible ischemic ... ) or metabolic liver ... #Hepatitis #AH ... #hepatology #criteria
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... Drugs/Toxins • Ischemia ... hepatitis • Drugs ... • Others #LFTs ... #Causes
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Vascular Causes ... , HBV, HCV, HEV, ... • Iatrogenic: DILI ... ALT Ratios: • Alcoholic ... #hepatology
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Causes of Acute ... : Alcohol, Medication ... Medication, Pregnancy, Alcoholic ... #Acute #algorithm ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
Drugs (MDMA), Alcohol ... • Vascular: Ischemic ... Differential #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... serologies, HCV ... ALT Ratios: • Alcoholic ... #differential #Hepatology ... transaminitis #LFTs
Alcoholic Hepatitis - Management Algorithm Assess Eligibility for Treatment: - Maddrey Discriminant Function ≥ (or possibly MELD
Alcoholic Hepatitis ... exclude other causes ... diseases including HBV ... HCV, DILI, HCC, ... #Algorithm #hepatology
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