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hepatology diagnosis liver differential lfts transaminitis treatment dili gastroenterology hbv hepatitisb aclf acute aih alcoholic autoimmune chemistry drug druginduced failure
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... Drug-Induced Liver Injury ... #ACLF #Acute #Chronic ... #Hepatology #gastroenterology
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver Injury ... CMV), Alcoholic cirrhosis ... 5-10x normal - Chronic ... Patterns #Liver #Injury ... #hepatology #LFTs
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
• NAFLD • Cirrhosis ... • Chronic Viral ... Hepatitis Moderate ... • Acute Viral Hepatitis ... Drug-induced liver injury
Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with
Chronic Hepatitis ... Algorithm • ... viremia or have cirrhosis ... Chronic Hepatitis ... #Hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... e.g. ascites), Chronic ... hepatitis fibrosis ... #Diagnosis #Algorithm ... #hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Differential Diagnosis Algorithm ... > 2 • NASH, Chronic ... : < 1 • Cirrhosis ... : > 3 • Chronic ... #hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Diagnosis and Management ... presentation • Chronic ... differential #Diagnosis #Management ... gastroenterology #algorithm ... gastroenterology #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
> 2 • NASH, Chronic ... viral hepatitis ... : < 1 • Cirrhosis ... : > 3 • Chronic ... #differential #Hepatology
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... or fibrosis • Cirrhosis ... with severe liver injury ... #Indications #management ... #hepatology
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
- Symptoms of chronic ... pattern of liver injury ... (eg Viral) Management ... AIH #Diagnosis #Management ... #Hepatology
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