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

DILI Types:
 • Intrinsic - predictable, dose dependent
Idiosyncratic Drug-induced Liver ... or symptoms of liver ... Drug #induced #Liver ... #algorithm #gastroenterology ... #hepatology
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury
Hepatocellular Liver Injury
 • AST/ALT elevation
Liver Enzymes (LFTs ... and Cholestatic Liver ... Liver Injury ... Transaminitis #diagnosis #differential ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework:
Liver Injury → liver test abnormalities without evidence of liver
Injury - Differential ... Injuryliver ... Injury Differential ... #Injury #Differential ... #LFTs #hepatitis
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... (Drug-induced liver ... injury) • Ischemic ... LouLectures #Liver ... Diagnosis #hepatology
Evaluation abnormal liver tests in pregnancy
- Cholestatic Pattern
- Hepatocellular Pattern

#LFTs #transaminits #pregnancy #obgyn #obstetrics #hepatology #diagnosis
Evaluation abnormal liver ... Hepatocellular Pattern #LFTs ... obgyn #obstetrics #hepatology ... #diagnosis #differential ... #algorithm
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
of Severe Acute Liver ... - Drug-Induced liver ... hepatitis - Wilson disease ... Acute #Causes #Differential ... #Hepatology #Diagnosis
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic Liver ... disease, liver ... Injury (DILI) ... Failure #Cirrhosis #Hepatology ... #gastroenterology
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... - Vitals - LFTs ... disease work up ... Calling #Referral #Hepatology ... #Gastroenterology
Liver Chemistries - Interpretation of LFTs

R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP)
 • R >
Interpretation of LFTs ... disease: > 2 ... chemistry #diagnosis #differential ... #Hepatology #transaminitis ... #LFTs #RValue #
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Causes of Acute Liver ... Injury - Differential ... Hepatocellular - Liver ... #Injury #Differential ... #hepatology