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diagnosis hepatology differential management transaminitis algorithm gastroenterology function hepatitis interpretation laboratory tests aclf aih arthritis autoimmune calling chemistry cirrhosis consultation
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Tests (LFTs) - ... Cirrhosis • Chronic ... Hepatopathy • Acute ... (>1000): • DILI ... injury) • Ischemic
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Injury (DILI) ... dose dependent injury ... presentation • Chronic ... - ongoing ↑ LFTs ... or symptoms of liver
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... involvement, Kidney injury ... dechallenge • Acute ... or chronic atypical ... e.g. ascites), Chronic
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... > 2 • NASH, Chronic ... > 3 • Chronic ... Unconjugated Bili ... transaminitis #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Liver Injury: ... Liver Injury: ... > 2 • NASH, Chronic ... > 3 • Chronic
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Liver Failure ( ... Injury (DILI) ... EmoryGastroHep #ACLF #Acute ... #Chronic #Liver
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
(LFTs) Elevation ... abnormality vs bone Bili ... Hepatocellular injury ... 2: Cholestatic injury ... #FunctionTest #LFTs
The Liver Consult Primer - Guide to calling a consult HPI: - Start with reason for consult
The Liver Consult ... Focus on prior Liver ... - Vitals - LFTs ... GTT, indirect bili ... current MELD - Chronic
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... Injury Transaminase ... > 20x normal - Acute ... 5-10x normal - Chronic ... #LFTs #transaminitis
Liver Function Tests (LFTs) - Normal Values and Interpretation Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
Liver Function Tests ... (LFTs) - Normal ... bilirubin (Conjugated/DBili ... hepatocellular injury ... Function #Tests #LFTs
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