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differential transaminitis algorithm causes hepatitis management elevation function gastroenterology interpretation laboratory lactate tests abnormal acidosis aclf aih albumin arterial ascites
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Elevated Liver Function ... Hepatopathy • Acute ... (>1000): • DILI ... injury) • Ischemic ... #hepatology #transaminitis
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
> 50x normal - Ischemic ... > 20x normal - Acute ... AST:ALT = 1 - Ischemia ... Viral Hepatitis, Ischemic ... #Injury #hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Diagnosis and Management ... Injury (DILI) ... Chronic - ongoing ↑ LFTs ... #differential #Diagnosis ... gastroenterology #hepatology
Causes of Severe Acute Liver Injury - Ichemic hepatitis - Acute biliary obstruction - Drug-Induced liver
Liver Injury ... - Ichemic hepatitis ... injury - Viral ... #Differential #Hepatology ... #Diagnosis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... disease, Hepatic ischaemia ... dechallenge • Acute ... #Injury #Diagnosis ... #Algorithm #hepatology
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
(LFTs) Elevation ... abnormality vs bone Bili ... #FunctionTest #LFTs ... Transaminitis #diagnosis ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
Diagnosis Framework ... : Liver Injury ... • Vascular: Ischemic ... #Diagnosis #hepatology ... Transaminitis #LFTs
Elevated Transaminases / Transaminitis - Differential Diagnosis • Infectious: HAV, HCV, HEV, EBV, HSV, CMV •
Elevated Transaminases ... 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 ... - Differential Diagnosis ... Drugs/Toxins • Ischemia ... • Others #LFTs ... #Hepatology #LiverEnzymes
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... specificity to elevated ... #chemistry #diagnosis ... #differential #Hepatology ... transaminitis #LFTs
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