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Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... months without treatment ... Injury (DILI) ... #Hepatology #gastroenterology
Table of Causes of Acute Liver Injury
#Diagnosis #Hepatology #Acute #Liver #Injury #Causes #Differential #Incidence #Table #Failure
Table of Causes ... of Acute Liver Injury ... #Diagnosis #Hepatology ... #Acute #Liver # ... Injury #Causes #
Focused evaluation algorithm for acute liver injury

#Liver #Injury #Acute #Evaluation #Algorithm #Diagnosis #Hepatology
algorithm for acute ... liver injury ... #Liver #Injury # ... Acute #Evaluation ... Algorithm #Diagnosis #Hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... • NAFLD • Cirrhosis ... Hepatopathy • Acute ... injury) • Ischemic ... Differential #Diagnosis #hepatology
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe Acute ... Liver Injury ... - Drug-Induced liver ... injury - Viral ... #Differential #Hepatology
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... Indications #Management #Cirrhosis ... #treatment #hepatology
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 ... Hepatobiliary #hepatology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... Injury Transaminase ... > 20x normal - Acute ... CMV), Alcoholic cirrhosis ... #Injury #hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Injury (DILI) ... dose dependent injury ... Diagnosis #Management #gastroenterology ... #algorithm #gastroenterology ... #hepatology
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... injury (INR > 2 ... > 3 mg/dL) or acute ... Indications #management #hepatology