DILI: Types of Liver Injury

Question 1

DILI definition (in terms of the lab values)

Answer 1

Total bili >2.5mg/dl with any elevation in ALT, ALT, ALP

ALT >5x ULN
AST >5x ULN
ALP >2x ULN
INR >1.5 with elevated AST, ALT, or ALP

Question 2

Types of DILI

Answer 2

Hepatocellular
Cholestatic
Mixed

Question 3

What happens in hepatocellular DILI?

Answer 3

Hepatocytes are affected

Question 4

What lab values are elevated in hepatocellular DILI?

Answer 4

AST and ALT

Question 5

Formula for hepatocellular DILI

Answer 5

R= [ALT/ULN]/[ALP/ULN] = ≥5

Question 6

What happens in cholestatic DILI?

Answer 6

Something is preventing the bile from moving from the liver to the duodenum

Question 7

What value is elevated in cholestatic DILI?

Answer 7

ALP

Question 8

Formula for cholestatic DILI

Answer 8

R= [ALT/ULN]/[ALP/ULN] = ≤2

Question 9

What happens in mixed DILI?

Answer 9

There’s hepatocellular and cholestatic injury

Question 10

Formula for mixed DILI

Answer 10

R= [ALT/ULN]/[ALP/ULN] =2-5

Question 11

Stuff for the formula: what’s the ULN value you use for ALT

Answer 11

40

Question 12

Stuff for the formula: what’s the ULN value you use for ALP?

Answer 12

140