Drug-Induced Liver Injury
Morning Report
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
