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Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... Tests (LFTs) - ... Hepatopathy • Acute ... (>1000): • DILI ... injury) • Ischemic
Liver Function Test (LFTs) Elevation
AST - Cardiac and skeletal muscle, kidney, brain
ALT - More specific for
Liver Function Test ... (LFTs) Elevation ... abnormality vs bone Bili ... Hepatocellular injury ... #FunctionTest #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Acute Liver Injury ... Liver Injury: ... Liver Injury: ... Tests of synthetic function ... ALT Ratios: • Alcoholic
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... involvement, Kidney injury ... HEV, EBV, CMV), Alcohol-related ... dechallenge • Acute ... #Injury #Diagnosis
Liver Chemistries - Interpretation of LFTs

R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP)
 • R >
Interpretation of LFTs ... ALT Ratios: • Alcoholic ... Unconjugated Bili ... > 90% of Total Bili ... transaminitis #LFTs
Liver Function Tests (LFTs) - Normal Values and Interpretation

Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
Liver Function Tests ... (LFTs) - Normal ... hepatocellular injury ... #Function #Tests ... #LFTs #Laboratory
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Liver Failure ( ... Failure Infections Alcohol-Associated ... Injury (DILI) ... EmoryGastroHep #ACLF #Acute
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... Injury Transaminase ... > 20x normal - Acute ... #Patterns #Liver ... #LFTs #transaminitis
Alcoholic Hepatitis - Management Algorithm
Assess Eligibility for Treatment:
 - Maddrey Discriminant Function ≥ (or possibly MELD
Alcoholic Hepatitis ... Maddrey Discriminant Function ... Treatment: - Acute ... kidney injury with ... HCV, DILI, HCC,