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

DILI Types:
 • Intrinsic - predictable, dose dependent
Idiosyncratic Drug-induced Liver ... presentation • Chronic ... or symptoms of liver ... Drug #induced #Liver ... #algorithm #gastroenterology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Drug Induced Liver ... for alternative causes ... Alcohol-related liver ... dechallenge • Acute ... #DrugInduced #Liver
Evaluation abnormal liver tests in pregnancy
- Cholestatic Pattern
- Hepatocellular Pattern

#LFTs #transaminits #pregnancy #obgyn #obstetrics #hepatology #diagnosis
Evaluation abnormal liver ... tests in pregnancy ... #obgyn #obstetrics ... hepatology #diagnosis #differential ... #algorithm
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Acute Liver Injury ... - Differential ... Vascular Causes ... of Acute Liver ... melanoma, myeloma • Pregnancy
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Liver Failure ( ... Injury (DILI) ... #Chronic #Liver ... Cirrhosis #Hepatology #gastroenterology
Thrombocytopenia and Pregnancy - TTP/HUS, HELLP Syndrome and Acute Fatty Liver of Pregnancy (AFLP)
Three syndromes in
HELLP Syndrome and Acute ... Fatty Liver of ... Hemolysis, Elevated Liver ... exchange 3) Fatty liver ... coagulation defects and liver
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... Cirrhosis • Chronic ... Hepatopathy • Acute ... (>1000): • DILI ... (Drug-induced liver
Acute Fatty Liver of Pregnancy (AFLP)
Pathophysiology:
 • Defect in fetal free fatty acid metabolism products →
Acute Fatty Liver ... hepatocytes → Liver ... liver failure rapidly ... Transfer to a liver ... #obstetrics #obgyn
Causes of Gallbladder Wall Thickening
Primary Wall Thickening:
1 . Acute calculous cholecystitis
2. Acute acalculous cholecystitis
3. Chronic cholecystitis
4.
Causes of Gallbladder ... Chronic cholecystitis ... Systemic Processes: Liver ... , Pregnancy, Total ... #differential #
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Causes of Acute ... Liver Injury - Differential ... Hepatocellular - Liver ... Artery: Shock Liver ... #Acute #algorithm