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diagnosis hepatology differential liver injury transaminitis gastroenterology aclf acute causes chemistry dili drug failure function hbv idiosyncratic induced interpretation liverenzymes
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Function Tests (LFTs ... • NAFLD • Cirrhosis ... • Chronic Viral ... Hepatitis Moderate ... • Acute Viral Hepatitis
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
- Acute Viral Hepatitis ... , Toxic Hepatitis ... CMV), Alcoholic cirrhosis ... 5-10x normal - Chronic ... #LFTs #transaminitis
Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with
Chronic Hepatitis ... serologic evidence of hepatitis ... viremia or have cirrhosis ... Chronic Hepatitis ... #HepatitisB #HBV
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... Alcohol-Associated Hepatitis ... (DILI) Viral Hepatitis ... #Hepatology #gastroenterology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Differential Diagnosis Algorithm ... • Alcoholic hepatitis ... Infiltrative • Cirrhosis ... • Others #LFTs ... #Hepatology #LiverEnzymes
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Check Acute viral hepatitis ... Check Acute viral hepatitis ... viral hepatitis ... : < 1 • Cirrhosis ... #RValue #interpretation
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Diagnosis and Management ... presentation • Chronic ... - ongoing ↑ LFTs ... Calculate R-Value ... gastroenterology #algorithm
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Autoimmune: Autoimmune hepatitis ... viral hepatitis ... : < 1 • Cirrhosis ... liver #injury #hepatitis ... #hepatology
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