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diagnosis differential causes management ascites lfts albumin chronic gradient hbv hepatitis injury saag transaminitis abnormal aclf acute aih autoimmune bariatric
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
those with CLD (± cirrhosis ... months without treatment ... (DILI) Viral Hepatitis ... #Failure #Cirrhosis ... #Hepatology #gastroenterology
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Non-Malignant • Fatty Liver ... • Right Heart Failure ... Cholangitis • Primary Biliary ... Cirrhosis #Hepatomegaly ... #Causes #Hepatology
Common Etiologies of Cirrhosis Inflammation - Hepatitis B (15 percent) - Hepatitis C (47 percent) - Schistosomiasis
Inflammation - Hepatitis ... congenital - Primary biliary ... Nonalcoholic fatty liver ... Congestive heart failure ... #Differential #Hepatology
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 Ascites - Differential Diagnosis Chronic liver disease (cirrhosis or chronic hepatitis) - 80% Underlying malignancy - 10% Congestive heart
Diagnosis Chronic liver ... disease (cirrhosis ... or chronic hepatitis ... , Pancreatic, Biliary ... Differential #Diagnosis #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... • Alcoholic hepatitis ... Infiltrative • Cirrhosis ... Duct Stone • Biliary ... Others #LFTs #Hepatology
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Congenital, Others, Cirrhosis ... Ducts - CBD ... stone, Biliary ... #diagnosis #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
protein ≤ 2.5 g/dL: Cirrhosis ... syndrome, Massive liver ... 2.5 g/dL: Heart failure ... syndrome SAAG < 1.1: Biliary ... albumin #gradient #hepatology
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
/Liver failure ... • ALP > 1.5 x ULN ... or higher • Liver ... Diagnosis: • Viral hepatitis ... diagnosis #workup #hepatology
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... IU/mL and ALT > ULN ... mg/dL) or acute liver ... failure #HepatitisB ... Indications #management #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... non-essential drug/HDS treatments ... Benign/malignant biliary ... • Autoimmune hepatitis ... #hepatology
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