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

DILI Types:
 • Intrinsic - predictable, dose dependent
Diagnosis and Management ... presentation • Chronic ... disease 6-9 mo ... Idiosyncratic #differential ... #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Disease (Cirrhosis ... Hepatopulmonary Syndrome ... • Hepatorenal Syndrom ... Complications #diagnosis #management ... #summary #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... disease, liver ... #ACLF #Acute #Chronic ... #Cirrhosis #Hepatology ... #gastroenterology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic ... liver disease ( ... Fitz-Hugh-Curtis syndrome ... #Diagnosis #hepatology
Bilateral Lower Extremity Swelling - Differential Diagnosis Framework
Acute:
 • DVT *Can't Miss Diagnosis
 • Medication Side
Diagnosis • Medication ... • Nephrotic Syndrome ... Chronic: • Venous ... DiseaseChronic ... Heart Failure • Liver
Chronic Diarrhea Differential Diagnosis
 • Inflammatory, Infectious: Recurrent C. diff, Giardiasis
 • Inflammatory, Non-infectious: IBD, Ischemia,
Chronic Diarrhea ... Differential Diagnosis ... overgrowth, Celiac disease ... #Differential # ... Diagnosis #causes #gastroenterology
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Injury - Differential ... Toxic: Alcohol, Medication ... obstruction, HELLP Syndrome ... #Injury #Differential ... Acute #algorithm #hepatology
Causes of Anemia by Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Low Mean Corpuscular Volume (<80
Volume (MCV) - Differential ... Renal Disease, Liver ... Reticulocytosis • Liver ... Classification #Differential ... Algorithm #Causes #Hematology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Nonalcoholic fatty liver ... heart failure (chronic ... (Budd-Chiari syndrome ... #Diagnosis #Differential ... #Hepatology #Cirrhosis
Hepatopulmonary Syndrome (HPS) 

HPS-differential diagnosis:
1. Pulmonary vasculature
2. Diseases of the lung parenchyma
3. Pleura and diaphragm

HPS-diagnosis:
1. Patients
(HPS) HPS-differential ... Diseases of the ... Patients with liver ... disease 2. ... #HPS #hepatology