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Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Schistosomiasis - Autoimmune ... Sarcoidosis Toxic - Alcohol ... Nonalcoholic fatty liver ... heart failure (chronic ... #Differential #Hepatology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... 5-10x normal - Chronic ... AST:ALT > 2.5 - Alcoholic ... #Patterns #Liver ... #Injury #hepatology
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
HSV • Toxic: Alcohol ... Other: NAFLD, Autoimmune ... hepatitis, Acute ... Medication, Pregnancy, Alcoholic ... Acute #algorithm #hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Non-Malignant • Fatty Liver ... Inflammatory • Alcoholic ... HepatitisAutoimmune ... Induced Hepatitis ... Algorithm #Causes #Hepatology
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
of Severe Acute Liver ... - Drug-Induced liver ... - Autoimmune ... hepatitis - Wilson ... #Differential #Hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Failure Infections Alcohol-Associated ... Hepatitis (AAH) ... #ACLF #Acute #Chronic ... #Cirrhosis #Hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... • Ischemia • Autoimmune ... • NAFLD • Alcohol ... hepatitis • Drugs ... Others #LFTs #Hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
HEV, EBV, CMV), Alcohol-related ... hepatitis fibrosis ... steatosis • Autoimmune ... hepatitis #DILI ... Diagnosis #Algorithm #hepatology
Clinical diagnosis of Alcoholic Hepatitis (AH)
 • Onset of jaundice within prior 8 weeks
 • Ongoing
Hepatitis (AH) ... ) or metabolic liver ... Possible drug-induced liver ... #Hepatitis #AH ... #hepatology #criteria
Clinical Diagnosis of Autoimmune Hepatitis
 - Onset of jaundice within prior 8 weeks
 - Ongoing consumption
Clinical Diagnosis of Autoimmune ... ) or metabolic liver ... Possible drug-induced liver ... SMA >1:80 #Autoimmune ... #Hepatology #AIH