Thank you Dr. Reynolds for an excellent presentation on drug-induced liver injury

Teaching Points

• Patterns of abnormal LFTS
  • Hepatocellular: high AST/ALT w/mild elevation in alk phos
  • Cholestatic: High alk phos w/ mild AST/ALT
• Causes of hepatocellular injurry
  • Alcohol: AST elevation greater than ALT
  • Viral: ALT elevation greater than AST
  • NAFLD/NASH: AST to ALT ratio typically 1
  • Toxins: NSAIDS, abx, statins, anti-epileptic drugs
  • Hereditary/autoimmune: hemochromatosis, autoimmune hepatitis, alpha-1-antitrypsin deficiency, Wilson’s disease
  • Shock: high elevations in AST/ALT
  • Non-hepatic causes: muscle disorders, thyroid issues, celiac disease, adrenal insufficiency, anorexia

Powerpoint:
Daily Report 7-12-16 Courtney Reynolds

Further Reading:
Drug-induced liver injury