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Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Idiosyncratic Drug-induced Liver ... Chronic - ongoing ↑ LFTs ... or symptoms of liver ... Drug #induced #Liver ... #algorithm #gastroenterology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... Hepatopathy • Acute ... (Drug-induced liver ... Hepatopathy (shock liver ... LouLectures #Liver
Evaluation abnormal liver tests in pregnancy
- Cholestatic Pattern
- Hepatocellular Pattern

#LFTs #transaminits #pregnancy #obgyn #obstetrics #hepatology #diagnosis
Evaluation abnormal liver ... Hepatocellular Pattern #LFTs ... hepatology #diagnosis #differential ... #algorithm
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
The Gastroenterology ... CBC - Coags, LFTs ... Focus on prior GI/Liver ... last meal - Treatment ... GregoryTBrennan #Liver
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Liver Failure ( ... months without treatment ... disease, liver ... Cirrhosis #Hepatology #gastroenterology
Hepatobiliary Manifestations of Sickle Cell Disease
Acute sickle cell hepatic crisis:
 • Fever, acute onset RUQ pain,
hepatic crisis: • Fever ... Supportive with treatment ... liver failure ... Liver transplant ... hepatology #hepatitis #differential
Upper GI Bleed - Management Algorithm

Upper GI bleed Suspected: Melena, hematemesis, coffee-ground emesis, BRBPR
Initial Stabilization
Concern for
Algorithm Upper ... Stabilization Concern for Liver ... GAVE (idiopathic, liver ... UGIB #GIBleed #Differential ... #gastroenterology
Liver Chemistries - Interpretation of LFTs

R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP)
 • R >
Liver Chemistries ... Interpretation of LFTs ... Hepatocellular Level ... chemistry #diagnosis #differential ... transaminitis #LFTs
Severe Ulcerative Colitis - Management Algorithms
 - Adult outpatients with moderate to severely active ulcerative colitis
Ulcerative Colitis - Management ... Algorithms - Adult ... hospitalized with acute ... #Algorithm #treatment ... #gastroenterology
Hepatocellular Liver Injury - Differential Diagnosis Framework:
Liver Injury → liver test abnormalities without evidence of liver
Hepatocellular Liver ... Injury → liver ... Hepatocellular Liver ... Diagnosis #hepatology #algorithm ... Transaminitis #LFTs