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Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... disease, liver ... Injury (DILI) ... Viral Hepatitis ... Cirrhosis #Hepatology #gastroenterology
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Acute Liver Injury ... Differential Diagnosis Algorithm ... • NASH, Chronic ... : > 3 • Chronic ... #injury #hepatitis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... disease, Hepatic ... e.g. ascites), Chronic ... hepatitis fibrosis ... #Algorithm #hepatology
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
of Severe Acute Liver ... Injury - Ichemic ... - Drug-Induced liver ... injury - Viral ... Wilson disease
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Injury - Differential ... Syndrome, Celiac Disease ... , Infiltrative Disease ... #Injury #Differential ... Causes #Acute #algorithm
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Injury (DILI) ... presentation • Chronic ... disease 6-9 mo ... Diagnosis #Management #gastroenterology ... #algorithm #gastroenterology
Hepatocellular Liver Injury - Differential Diagnosis Framework:
Liver Injury → liver test abnormalities without evidence of liver
Injuryliver ... • Infections: Hepatitis ... HELLP, Celiac disease ... Diagnosis #hepatology #algorithm ... Transaminitis #LFTs #hepatitis
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... Injury Transaminase ... 5-10x normal - Chronic ... #Patterns #Liver ... #Injury #hepatology
Chronic Hepatitis B - Diagnosis and Management Algorithm

• Who to treat: Essentially treat the pts with
Chronic Hepatitis ... and Management Algorithm ... • Liver is the ... Chronic Hepatitis ... #Algorithm #Diagnosis
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... Cirrhosis • Chronic ... Viral Hepatitis ... • Acute Viral Hepatitis ... injury) • Ischemic