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diagnosis liver differential management lfts transaminitis aclf aih autoimmune causes chemistry cirrhosis druginduced failure function gastroenterology interpretation patterns rvalue tests
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Diagnosis Algorithm ... non-essential drug/HDS treatments ... HEV, EBV, CMV), Alcohol-related ... dechallenge • Acute ... #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... months without treatment ... Drug-Induced Liver Injury ... (DILI) Viral Hepatitis ... Failure #Cirrhosis #Hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Cirrhosis • Chronic ... Hepatopathy • Acute ... (>1000): • DILI ... Drug-induced liver injury ... Differential #Diagnosis #hepatology
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver Injury ... > 20x normal - Acute ... 5-10x normal - Chronic ... Patterns #Liver #Injury ... #hepatology #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Differential Diagnosis Algorithm ... ALT Ratios: • Alcoholic ... > 3 • Chronic ... #hepatology
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Liver Injury - Differential ... HSV • Toxic: Alcohol ... Medication, Pregnancy, Alcoholic ... Sophia_Hayes_MD #Liver #Injury ... #algorithm #hepatology
Alcoholic Hepatitis - Management Algorithm 1. Severity assessed not only by MDF (>32) but also by MELD
Alcoholic Hepatitis ... - Management Algorithm ... only increase short-term ... #Algorithm #treatment ... #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
viral hepatitis ... ALT Ratios: • Alcoholic ... > 2 • NASH, Chronic ... > 3 • Chronic ... #differential #Hepatology
Alcoholic Hepatitis - Management Algorithm Assess Eligibility for Treatment: - Maddrey Discriminant Function ≥ (or possibly MELD
Alcoholic Hepatitis ... - Management Algorithm ... injury with serum ... HCV, DILI, HCC, ... #Algorithm #hepatology
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
subclinical disease to acute ... - Symptoms of chronic ... pattern of liver injury ... regarding need for treatment ... Diagnosis #Management #Hepatology
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