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

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
those with CLD (± cirrhosis ... months without treatment ... Injury (DILI) ... Viral Hepatitis ... #Hepatology #gastroenterology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... Injury Transaminase ... CMV), Alcoholic cirrhosis ... #Patterns #Liver ... #Injury #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
• NAFLD • Cirrhosis ... Chronic Viral Hepatitis ... • Acute Viral Hepatitis ... injury) • Ischemic ... Differential #Diagnosis #hepatology
Here is a quick guide on the common direct-acting antivirals (DAAs) for chronic hepatitis C virus
DAAs) for chronic hepatitis ... DAAs #Antivirals #table ... #treatment #hcv ... infectiousdisease #hepatology ... #HepC #HepatitisC
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
of Severe Acute Liver ... Injury - Ichemic ... - Drug-Induced liver ... injury - Viral ... #Differential #Hepatology
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 ... Injury #Causes # ... Differential #Incidence #Table
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Inflammation - Hepatitis ... 15 percent) - Hepatitis ... Nonalcoholic fatty liver ... #Differential #Hepatology
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... or fibrosis • Cirrhosis ... injury (INR > 2 ... failure #HepatitisB ... Indications #management #hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Non-Malignant • Fatty Liver ... Infectious • Hepatitis ... • Alcoholic Hepatitis ... Primary Biliary Cirrhosis ... Algorithm #Causes #Hepatology
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Injury - Differential ... • Infectious: Hepatitis ... NAFLD, Autoimmune hepatitis ... #Injury #Differential ... Acute #algorithm #hepatology