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diagnosis differential injury causes abnormal chemistry druginduced function hepatocellular interpretation liverenzymes liverfunctiontests patterns rvalue tests transaminases
Elevated Transaminases / Transaminitis - Differential Diagnosis • Infectious: HAV, HCV, HEV, EBV, HSV, CMV •
Trauma: Shock liver ... • Autoimmune hepatitis ... • Iatrogenic: DILI ... #hepatitis #Differential ... Diagnosis #causes #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Elevated Liver Function ... Chronic Viral Hepatitis ... • Acute Viral Hepatitis ... (>1000): • DILI ... #transaminitis
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Hepatitis > ... - Acute Viral Hepatitis ... , Toxic Hepatitis ... #Injury #hepatology ... #LFTs #transaminitis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
, HBV, HCV, HEV, ... Hepatic ischaemia ... ascites), Chronic hepatitis ... • Autoimmune hepatitis ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
• Infections: Hepatitis ... • Vascular: Ischemic ... Differential #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
, HBV, HCV, HEV, ... Autoimmune: Autoimmune hepatitis ... Chronic viral hepatitis ... #injury #hepatitis ... #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Check Acute viral hepatitis ... Check Acute viral hepatitis ... specificity to elevated ... Chronic viral hepatitis ... #transaminitis
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... Drugs/Toxins • Ischemia ... • Alcoholic hepatitis ... • Others #LFTs ... #Hepatology #LiverEnzymes
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Drugs, Viral, Ischemia ... Burak @kwburak #LFTs ... #Elevated #Abnormal ... #hepatology #LiverFunctionTests
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