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differential transaminitis injury function gradient interpretation saag tests abnormal causes chemistry drug druginduced elevated hepatitis hepatocellular idiosyncratic induced laboratory liverenzymes
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Diagnosis and Management ... Chronic - ongoing ↑ LFTs ... #differential #Diagnosis ... #algorithm #gastroenterology ... #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
Diagnosis of ascites ... albumin gradient ... syndrome, Massive liver ... #hepatology #differential ... #diagnosis #algorithm
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Tests (LFTs) - ... Differential Diagnosis ... (>1000): • DILI ... injury) • Ischemic ... #hepatology #transaminitis
Ascites - Differential Diagnosis and Workup Algorithm • Perform paracentesis: • Cell count and diff • Total
Diagnosis and Workup ... Algorithm • ... and serum albumin ... #Algorithm #gastroenterology ... #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis ... Algorithm DILI ... disease, Hepatic ischaemia ... disorder (e.g. ascites ... #Algorithm #hepatology
Liver Function Tests (LFTs) - Normal Values and Interpretation Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
(LFTs) - Normal ... Crigler-Najjar) Albumin ... Function #Tests #LFTs ... Interpretation #diagnosis ... #hepatology
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
Serum Ascites Albumin ... - Differential Diagnosis ... - Massive liver ... associated with bowel ischemia ... #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... Algorithm Severe ... Drugs/Toxins • Ischemia ... • Others #LFTs ... #Hepatology #LiverEnzymes
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
- Differential Diagnosis ... • Vascular: Ischemic ... #Differential #Diagnosis ... #hepatology #algorithm ... Transaminitis #LFTs
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... Production: • Albumin ... #chemistry #diagnosis ... #differential #Hepatology ... transaminitis #LFTs
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