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diagnosis differential transaminitis injury hepatitis abnormal causes chemistry drug druginduced enzymes function gastroenterology hepatocellular idiosyncratic induced interpretation liverenzymes liverfunctiontests management
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Elevated Liver Function ... 100-500): • NAFLD ... (>1000): • DILI ... injury) • Ischemic ... Differential #Diagnosis #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... Drugs/Toxins • Ischemia ... ALT < 5x ULN • NAFLD ... • 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 ... #diagnosis #hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Chronic - ongoing ↑ LFTs ... or symptoms of liver ... Drug #induced #Liver ... gastroenterology #algorithm ... gastroenterology #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... Stepwise Diagnosis Algorithm ... disease, Hepatic ischaemia ... Injury #Diagnosis #Algorithm ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
• Vascular: Ischemic ... antitrypsin • Other: NAFLD ... Differential #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Elevated Transaminases / Transaminitis - Differential Diagnosis • Infectious: HAV, HCV, HEV, EBV, HSV, CMV •
Elevated Transaminases ... Trauma: Shock liver ... • Iatrogenic: DILI ... See Updated Schema ... Diagnosis #causes #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... specificity to elevated ... Unconjugated Bili ... #differential #Hepatology ... transaminitis #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Differential Diagnosis Algorithm ... • Iatrogenic: DILI ... specificity to elevated ... differential #diagnosis #algorithm ... #hepatology
Abnormal liver function tests algorithm. This figure details the initial response to abnormal liver blood tests.
tests algorithm ... a diagnosis of NAFLD ... dehydrogenase; NAFLD ... #LFTs #Abnormal ... #Algorithm #Hepatology
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