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differential transaminitis algorithm injury causes acute elevated management abnormal aclf ah aih albumin alcoholic ascites autoimmune chemistry chronic cirrhosis coagulation
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Tests (LFTs) - ... Differential Diagnosis ... (>1000): • DILI ... injury) • Ischemic ... #hepatology #transaminitis
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
> 50x normal - Ischemic ... AST:ALT = 1 - Ischemia ... , Ischemic Necrosis ... #Injury #hepatology ... #LFTs #transaminitis
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
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis ... disease, Hepatic ischaemia ... • Autoimmune hepatitis ... #Diagnosis #Algorithm ... #hepatology
Causes of Severe Acute Liver Injury - Ichemic hepatitis - Acute biliary obstruction - Drug-Induced liver
of Severe Acute Liver ... Injury - Ichemic ... - Drug-Induced liver ... #Differential #Hepatology ... #Diagnosis
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
• Infections: Hepatitis ... • Vascular: Ischemic ... #hepatology #algorithm ... Transaminitis #LFTs ... #hepatitis
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Injury (DILI) ... Viral Hepatitis ... Failure #Cirrhosis #Hepatology ... #gastroenterology ... #management #diagnosis
Elevated Transaminases / Transaminitis - Differential Diagnosis • Infectious: HAV, HCV, HEV, EBV, HSV, CMV •
- Differential Diagnosis ... Trauma: Shock liver ... • Iatrogenic: DILI ... See Updated Schema ... #causes #hepatology
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
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... Check Acute viral hepatitis ... #chemistry #diagnosis ... #differential #Hepatology ... transaminitis #LFTs
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