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diagnosis differential transaminitis management abnormal aclf acute calling chemistry consultation drug druginduced elevated failure function hbv hepatitis hepatitisb idiosyncratic induced
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Injury (DILI) ... presentation • Chronic ... - ongoing ↑ LFTs ... #algorithm #gastroenterology ... #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
• NAFLD • Cirrhosis ... • Chronic Viral ... (>1000): • DILI ... injury) • Ischemic ... Differential #Diagnosis #hepatology
The Liver Consult Primer - Guide to calling a consult HPI: - Start with reason for consult
The Liver Consult ... Gl History - Cirrhosis ... - Vitals - LFTs ... current MELD - Chronic ... #Gastroenterology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... Injury (DILI) ... #Cirrhosis #Hepatology ... #gastroenterology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Differential Diagnosis Algorithm ... • Iatrogenic: DILI ... hepatitis: < 1 • Cirrhosis ... #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... Stepwise Diagnosis Algorithm ... dechallenge • Acute or chronic ... e.g. ascites), Chronic ... #Algorithm #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... hepatitis: < 1 • Cirrhosis ... : > 3 • Chronic ... #differential #Hepatology ... transaminitis #LFTs
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... CMV), Alcoholic cirrhosis ... 5-10x normal - Chronic ... #Injury #hepatology ... #LFTs #transaminitis
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Ducts - PBC ... Congenital, Others, Cirrhosis ... Burak @kwburak #LFTs ... #diagnosis #hepatology
Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with
and Management Algorithm ... viremia or have cirrhosis ... • Monitor: CBC ... HepatitisB #HBV #Algorithm ... Management #Treatment #Hepatology
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