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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 ... disease 6-9 mo ... Drug #induced #Liver ... Idiosyncratic #differential
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Drug Induced Liver ... Alcohol-related liver ... disease, Hepatic ... #DrugInduced #Liver ... #hepatology
Hepatobiliary Manifestations of Sickle Cell Disease
Acute sickle cell hepatic crisis:
 • Fever, acute onset RUQ pain,
hepatic crisis: • Fever ... Supportive with treatment ... cholestasis: • Fever ... progressing to acute liver ... Liver transplant
Approach to Hypoproliferative Macrocytic Anemia

 • 812, Folate Deficiency
 • MDS+
 • Hypothyroid
 • Liver Disease
Hypothyroid • Liver ... Disease • Alcohol ... Macrocytic #Anemia #differential ... #diagnosis #algorithm ... #hematology #workup
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic Liver ... months without treatment ... disease, liver ... Injury (DILI) ... Failure #Cirrhosis #Hepatology
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
- Differential ... Diagnosis Algorithm ... injury #hepatitis #differential ... #diagnosis #algorithm ... #hepatology
Liver Mass - Differential Diagnosis Algorithm
Benign Cystic 
 • Cyst
 • Polycystic Liver Disease
 • Caroli's
Liver Mass - Differential ... • Polycystic Liver ... Disease • Caroli's ... Colon, Breast) #Liver ... #Mass #Hepatology
Liver Mass - Differential Diagnosis Algorithm
Cystic:
 • Benign 
     - Simple: Simple
Liver Mass - Differential ... cyst, Polycystic Liver ... Disease, Caroli's ... Burak @kwburak #Liver ... #Causes #Hepatology
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Focus on prior Liver ... disease work up ... - Prior liver biopsy ... Calling #Referral #Hepatology
Elevated Transaminases / Transaminitis - Differential Diagnosis

 • Infectious: HAV, HCV, HEV, EBV, HSV, CMV
 •
Transaminitis - Differential ... Trauma: Shock liver ... Metabolic: Wilson Disease ... • Iatrogenic: DILI ... Diagnosis #causes #hepatology