Acute liver failure causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Overview

There are various causes that can lead to the development of acute liver failure, the most common of which is acetaminophen overdose, usually as a consequence of attempted suicide. Other toxins such as alcohol, poisonous mushrooms, and other medications can also lead to the development of acute liver failure. It can also be idiopathic, or as a consequence of other diseases or conditions such as; Wilson's disease, autoimmune hepatitis, Reye syndrome, viral hepatitis, parvovirus B19 infection, and acute fatty liver of pregnancy.

Causes

Common Causes

• Acetaminophen overdose is the most common cause. The reason is usually suicidal intent. Additionally, the toxic threshold dose of acetaminophen decreases in some cases such as in chronic alcoholics, diabetics, and while fasting.
• Idiosyncratic reactions to medication is the second most common cause. Culprit drugs are: tetracycline, troglitazone, antituberculosis drugs, and anti-epileptic drugs
• Excessive alcohol intake and severe alcoholic hepatitis
• Viral hepatitis (hepatitis A or B). The incidences of acute liver failure in post-viral hepatitis has decreased due to the extensive vaccination against these infections.
• Autoimmune hepatitis
• Acute fatty liver of pregnancy
• Reye syndrome is acute liver failure in a child with a viral infection (e.g. chickenpox); it appears that aspirin use may play a significant role
• Wilson's disease (hereditary copper accumulation) may infrequently present with acute liver failure
• Idiopathic (without an obvious cause)
• Diseases of fatty acid oxidation pathways
• Parvovirus B19 infection
• Budd–Chiari syndrome
• Malignancy such as lymphomas
• Shock
• Hyperthermia
• Hypothermia

Causes by Organ System

Cardiovascular	Cardiomyopathy, Congestive heart failure, Heart surgery, Hypoplastic left heart syndrome, Hypotension, Myocarditis, Shock
Chemical / poisoning	8-Hyydroxyquinoline, Amanita phalloides, Amatoxins, Carbon tetrachloride, Ethanol, Gold, Gyromitrin, Iron compounds, Mushroom poisoning, Senecio, Toluene, Yellow phosphorous, Bacillus cereus , Cyanobacteria
Dermatologic	No underlying causes
Drug Side Effect	Abacavir, Acetaminophen, Acetaminophen and Oxycodone, Albendazole, Allopurinol, Amiodarone, Amitriptyline, Ampicillin, Amoxicillin-clavulanate, Anticonvulsants, Antituberculosis drugs, Aspirin, Atorvastatin, Bromfenac , Carbamazepine, Chaparral, Chelidonium, Ciprofloxacin, Comfrey, Cyclophosphamide, Dantrolene, Dapsone, diclofenac (patch), Didanosine, Dideoxyinosine, Disulfiram, Doxycycline, Efavirenz, Ephedra, Erlotinib, Erythromycin, Etodolac, Fluoroquinolones, Flutamide, Gemtuzumab, Gemtuzumab, Germander tea, Ginseng, Halothane, He Shou Wu, Hydroxychloroquine, Imipramine, Interferon beta, Isoflurane, Isoniazid, Ixabepilone, Kava kava, Ketoconazole, Labetalol, Leflunomide, Loratadine, Lovastatin, Ma Huang, MAO inhibitors, Meloxicam, Methotrexate, Methyldopa, Moxifloxacin, Niacin, Nevirapine, Nicotinic acid, Nitisinone, Nitrofurantoin, Nortriptyline, NSAIDs, Oral contraceptive pills , Pazopanib, Pemoline, Pennyroyal, Phenytoin, Propylthiouracil, Pyrazinamide, Regorafenib, Rifampin, Simvastatin, Skull cap, Statins, Sulfacetamide, Sulfasalazine, Suloctidil, Terbinafine, Tetracycline, Teucrium polium, Tolcapone, Tricyclic antidepressants, Troglitazone, Valproic acid, Ecstacy, Cocaine, Reye's syndrome
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Budd-Chiari syndrome, Cirrhosis, Hepatic arterial thrombosis, Hepatic veno-occlusive disease, Ischemic hepatitis, Portal vein thrombosis, Alpha1-antitrypsin deficiency, Acute fatty liver of pregnancy, Liver tumor, Autoimmune hepatitis
Genetic	Alpha1-antitrypsin deficiency, Carnitine palmitoyltransferase 1 deficiency, Fructose intolerance, Galactosemia, Hemochromatosis, LCAT deficiency, Sickle cell disease, Tyrosinemia, Wilson's disease, HELLP syndrome
Hematologic	Hemosiderosis, Hemochromatosis, Sickle cell disease, HELLP syndrome, Leukemia
Iatrogenic	Extracorporeal membrane oxygenation, Hepatectomy, Reye's syndrome
Infectious Disease	Adenovirus, Bacillus cereus , Cyanobacteria, Cytomegalovirus, Echovirus, Epstein-Barr virus, Fasciola hepatica, Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, Herpes simplex, Leptospirosis, Non A non B hepatitis , Parainfluenza viruses, Parvovirus, Sepsis, Viral hemorrhagic fever, Viral hepatitis, Visceral leishmaniasis
Musculoskeletal / Ortho	Adult onset Still's disease
Neurologic	No underlying causes
Nutritional / Metabolic	Fatty acid oxidation pathway diseases, Hemochromatosis, Carnitine palmitoyltransferase 1 deficiency, Fructose intolerance, Galactosemia, LCAT deficiency, Tyrosinemia, Wilson's disease
Obstetric/Gynecologic	Acute fatty liver of pregnancy, HELLP syndrome
Oncologic	Leukemia, Liver tumor
Opthalmologic	No underlying causes
Overdose / Toxicity	Abacavir, Acetaminophen, Allopurinol, Amiodarone, Amitriptyline, Ampicillin, Amoxicillin-clavulanate, Anticonvulsants, Antituberculosis drugs, Aspirin, Atorvastatin, Bromfenac , Carbamazepine, Chaparral, Chelidonium, Ciprofloxacin, Comfrey, Cyclophosphamide, Dantrolene, Dapsone, Didanosine, Dideoxyinosine, Disulfiram, Doxycycline, Efavirenz, Ephedra, Erlotinib, Erythromycin, Etodolac, Fluoroquinolones, Flutamide, Gemtuzumab, Gemtuzumab, Germander tea, Ginseng, Halothane, He Shou Wu, Imipramine, Interferon beta, Isoflurane, Isoniazid, Kava kava, Ketoconazole, Labetalol, Leflunomide, Lovastatin, Ma Huang, MAO inhibitors, Methotrexate, Methyldopa, Moxifloxacin, Nevirapine, Nicotinic acid, Nitisinone, Nitrofurantoin, Nortriptyline, NSAIDs, Oral contraceptive pills , Pazopanib, Pemoline, Pennyroyal, Phenytoin, Propylthiouracil, Pyrazinamide, Regorafenib, Rifampin, Simvastatin, Skull cap, Statins, Sulfasalazine, Suloctidil, Terbinafine, Tetracycline, Teucrium polium, Tolcapone, Tricyclic antidepressants, Troglitazone, Valproic acid, Ecstacy, Cocaine
Psychiatric	No underlying causes
Pulmonary	Asphyxia, Alpha1-antitrypsin deficiency
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Autoimmune hepatitis, Graft versus host disease
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Alcohol, Cocaine, Cryptogenic, Ecstacy, Heat stroke, Hyperthermia, Hypothermia

Causes in Alphabetical Order

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