{"uid":"cap_rDefqGiirEPuygVkCc6hr","slug":"tokyo-guidelines-2018-cholangitis-diagnosis-severity-grader-d144a73c","name":"Tokyo Guidelines 2018 Cholangitis Diagnosis & Severity Grader","description":"Kiriyama 2018 TG18 (=TG13) cholangitis. Definite if one A (fever/chills or elevated WBC/CRP), one B (jaundice or abnormal LFTs), and one C (dilatation or etiology); suspected if A plus B or C; else none. Grade III if any organ dysfunction, else Grade II if any two of WBC, fever >=39C, age >=75, bilirubin >=5, or hypoalbuminemia, else Grade I. Severity none if diagnosis none. Not cholecystitis or Alvarado/RIPASA. magent does not examine, assay, or read imaging. Not a medical device.","url":"https://api.magentlab.com/api/calc/tokyo_cholangitis","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET","HEAD","DELETE"],"type":"string"},"headers":{"type":"object","additionalProperties":{"type":"string"}},"queryParams":{"type":"object","required":["age","fever_or_chills","elevated_wbc_or_crp","jaundice","abnormal_lfts","biliary_dilatation","etiology_on_imaging","hypotension_vasopressors","decreased_consciousness","pfr_lt_300","oliguria_or_creatinine_gt_2","pt_inr_gt_1_5","platelets_lt_100k","wbc_gt_12k_or_lt_4k","fever_ge_39","bilirubin_ge_5","hypoalbuminemia"],"properties":{"age":{"type":"integer","description":"Age in years (18-120). Counts as one Kiriyama 2018 TG18 Grade II item when age ≥75. Age 75 meets; age 74 does not. magent does not examine the patient."},"jaundice":{"type":"boolean","description":"Jaundice as assigned by the caller (Kiriyama 2018 TG18 B-1). true or false. magent does not examine the patient."},"pfr_lt_300":{"type":"boolean","description":"PaO2/FiO2 <300 as assigned by the caller (Kiriyama 2018 TG18 Grade III respiratory dysfunction). true or false. magent does not interpret blood gas or ventilator settings."},"fever_ge_39":{"type":"boolean","description":"Fever ≥39°C as assigned by the caller (Kiriyama 2018 TG18 Grade II). true or false. magent does not measure temperature."},"abnormal_lfts":{"type":"boolean","description":"Increased ALP, GGT, AST, or ALT as assigned by the caller (Kiriyama 2018 TG18 B-2). true or false. magent does not assay liver tests."},"pt_inr_gt_1_5":{"type":"boolean","description":"PT-INR >1.5 as assigned by the caller (Kiriyama 2018 TG18 Grade III hepatic dysfunction). true or false. magent does not interpret coagulation assays."},"bilirubin_ge_5":{"type":"boolean","description":"Total bilirubin ≥5 mg/dL as assigned by the caller (Kiriyama 2018 TG18 Grade II). true or false. magent does not assay bilirubin."},"fever_or_chills":{"type":"boolean","description":"Fever and/or shaking chills as assigned by the caller (Kiriyama 2018 TG18 A-1). true or false. magent does not measure temperature or examine the patient."},"hypoalbuminemia":{"type":"boolean","description":"Albumin <0.7× the local lower limit of normal as assigned by the caller (Kiriyama 2018 TG18 Grade II). true or false. magent does not assay albumin."},"platelets_lt_100k":{"type":"boolean","description":"Platelet count <100,000/mm³ as assigned by the caller (Kiriyama 2018 TG18 Grade III hematological dysfunction). true or false. magent does not assay platelets."},"biliary_dilatation":{"type":"boolean","description":"Biliary dilatation as assigned by the caller (Kiriyama 2018 TG18 C-1). true or false. magent does not read imaging."},"elevated_wbc_or_crp":{"type":"boolean","description":"Laboratory inflammatory response (elevated WBC or CRP) as assigned by the caller (Kiriyama 2018 TG18 A-2). true or false. magent does not assay WBC or CRP."},"etiology_on_imaging":{"type":"boolean","description":"Evidence of etiology on imaging (stricture, stone, stent, or equivalent) as assigned by the caller (Kiriyama 2018 TG18 C-2). true or false. magent does not read imaging."},"wbc_gt_12k_or_lt_4k":{"type":"boolean","description":"White blood cell count >12,000/mm³ or <4,000/mm³ as assigned by the caller (Kiriyama 2018 TG18 Grade II). true or false. magent does not assay WBC."},"decreased_consciousness":{"type":"boolean","description":"Decreased level of consciousness as assigned by the caller (Kiriyama 2018 TG18 Grade III neurological dysfunction). true or false. magent does not examine the patient."},"hypotension_vasopressors":{"type":"boolean","description":"Hypotension requiring dopamine ≥5 µg/kg/min or any norepinephrine as assigned by the caller (Kiriyama 2018 TG18 Grade III cardiovascular dysfunction). true or false. magent does not measure blood pressure or order vasopressors."},"oliguria_or_creatinine_gt_2":{"type":"boolean","description":"Oliguria or creatinine >2.0 mg/dL as assigned by the caller (Kiriyama 2018 TG18 Grade III renal dysfunction). true or false. magent does not assay creatinine or measure urine output."}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object"}}}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.005","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.005/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_q6kNJL0yv-TgmPnU9M_0X","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.005","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Applies the Kiriyama 2018 TG18 criteria to classify acute cholangitis as definite, suspected, or none, and grades severity as Grade I, II, or III based on caller-supplied clinical findings.","exampleAgentPrompt":"Score this patient for acute cholangitis using the Tokyo Guidelines 2018: 62-year-old with fever and chills, elevated WBC and CRP, jaundice, abnormal LFTs, biliary dilatation on imaging with a known etiology — no organ dysfunction, no fever above 39°C, bilirubin under 5, no hypoalbuminemia.","exampleUseCases":[{"title":"ED triage of suspected cholangitis","prompt":"I have a 78-year-old patient in the ED with fever and chills, elevated WBC and CRP, jaundice, and abnormal LFTs, but no biliary dilatation or etiology on imaging. There's no organ dysfunction, but fever is above 39°C and bilirubin is 6 mg/dL. Can you run the TG18 cholangitis scoring for me?"},{"title":"Post-ERCP severity reassessment","prompt":"After ERCP we found biliary dilatation and a clear etiology. Patient is 80 years old, has jaundice, abnormal LFTs, elevated CRP, and hypoalbuminemia, but no organ dysfunction and bilirubin is 3 mg/dL, no fever above 39. What does TG18 say about cholangitis diagnosis and severity grade?"},{"title":"ICU patient with organ failure workup","prompt":"My ICU patient is 55 years old, has fever and chills, elevated WBC, jaundice, abnormal LFTs, biliary dilatation and etiology confirmed. They're also hypotensive requiring vasopressors, their PT-INR is 1.8, creatinine is 2.5, and platelets are 90k. What's the TG18 cholangitis diagnosis and grade?"}],"resultDescription":"Returns the TG18 cholangitis diagnosis category (definite, suspected, or none) and severity grade (Grade I, II, III, or none if diagnosis is none), computed strictly from the caller-supplied boolean and integer inputs according to the Kiriyama 2018 algorithm.","failureModes":["Missing required query parameters returns a validation error","Age outside the accepted range (18–120) may be rejected","Inconsistent flag combinations (e.g. Grade III organ flags without diagnosis criteria) will still be processed by algorithm logic with no additional warning","No imaging, lab, or physical exam is performed — results depend entirely on caller accuracy"],"whenToPreferThis":"Use this endpoint when you need a structured, reproducible implementation of the Kiriyama 2018 TG18 cholangitis diagnostic and severity algorithm in an automated workflow, EHR integration, or clinical decision-support pipeline. Prefer this over manual scoring when auditability and API-level traceability are needed. Not appropriate for cholecystitis (separate condition), Alvarado/RIPASA appendicitis scoring, or any case where imaging or lab interpretation is required — callers must supply pre-interpreted findings.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T19:09:38.680Z","isFirstParty":false}