9 results
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Levels: > 50x normal ... > 20x normal ... , Toxic Hepatitis ... - Infection (EBV ... - Hemolysis, NASH
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Intravascular Hemolysis ... and RES-mediated hemolysis ... Drug-induced AIHA - Abnormal ... Cold AIHA • PCH ... • PNH
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
HBV, HCV, HEV, EBV ... - If both are normal ... Chronic viral hepatitis ... Bilirubin: RBC (hemolysis ... liver #injury #hepatitis
Elevated Lactate Dehydrogenase (LDH) - Differential Diagnosis Framework

LDH is a cytoplasmic enzyme present in tissues throughout
upon damage • Normal ... anemia, PNH, immune ... • Early acute hepatitis ... • Ischemic hepatitis ... 1.5) from viral hepatitis
Hemolysis in Hereditary Spherocytosis. Panel A shows the structure of a normal red cell and a
Hemolysis in Hereditary ... structure of a normal ... destruction or hemolysis ... Pathophysiology #Honc ... HereditarySpherocytosis #NEJM
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... Drug-associated, PCH ... Liver Disease, PNH ... Blood Smear ↑ abnormal ... Urobilinogen #Hemolysis
Paraproteinemias

Entities That Can Feature A Monoclonal Protein/M Component:
• MM
• WM
• MGUS
• MGCS
• MGRS
• Splenic Marginal Zone
Cryoglobulinemic, Hypo/normo-complementemic ... WAIHA • CAD • PCH ... Evans • ITP • Cl-NH ... • Coombs (-) hemolytic
Vasculitis - Differential Diagnosis Framework

When to Consider Vasculitis:
• Purpura, ischemic skin lesions
• Mononeuritis multiplex
• Hematuria, proteinuria,
strength & enzymes normal ... pulmonary infiltrates, hemoptysis ... infiltrates/cavities, hemoptysis ... pain and GN Anti-GBM ... - interstitial keratitis
Elevated Globulin - Protein Gap (Total Protein - Albumin > 4)

Work-up of an Elevated Globulin Gap:
•
acute HIV, HBV, EBV ... , VZV, hepatitis ... ETOH, autoimmune hepatitis ... , PBC, PSC, Viral ... light chain • Normal