Acute liver failure differential diagnosis: Difference between revisions
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Cholestasis | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Cholestasis | ||
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* Jaundice can be seen due to Intra or extrahepatic biliary obstruction, as well as intrahepatic cholestasis due to conditions like drug-induced liver injury | * [[Jaundice]] can be seen due to Intra or extrahepatic [[biliary obstruction]], as well as intrahepatic [[cholestasis]] due to conditions like drug-induced liver injury. | ||
* The absence of hepatic encephalopathy and coagulopathy will differentiate it from acute liver failure. | * The absence of [[hepatic encephalopathy]] and [[coagulopathy]] will differentiate it from acute liver failure. | ||
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* Absence of hepatic encephalopathy. | * Absence of [[Hepatic encephalopathy|hepatic encephalopathy.]] | ||
* Normal PT/INR. | * [[INR|Normal PT/INR.]] | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hemolysis | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hemolysis | ||
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* May have jaundice with increased | * May have [[jaundice]] with increased ([[Unconjugated bilirubin|unconjugated]]) indirect serum [[bilirubin]]. | ||
* Liver dysfunction may not be present. So, coagulopathy and hepatic encephalopathy would not be there. | * Liver dysfunction may not be present. So, [[coagulopathy]] and [[hepatic encephalopathy]] would not be there. | ||
* Common examples are hemolytic anemias. | * Common examples are [[hemolytic anemias]]. | ||
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* Absence of hepatic encephalopathy. | * Absence of [[Hepatic encephalopathy|hepatic encephalopathy.]] | ||
* Normal PT/INR. | * Normal [[Prothrombin time|PT/INR]]. | ||
* Abnormal peripheral blood smear. | * Abnormal [[Peripheral blood smear|peripheral blood smear.]] | ||
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Revision as of 16:58, 1 December 2017
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Acute liver failure Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]
Overview
Acute liver failure must be differentiated from other diseases that cause signs and symptoms of jaundice, coagulopathy, and encephalopathy. The differentials include acute hepatitis, cholestatic jaundice, and hemolytic jaundice. The common causes of acute hepatitis causing acute liver failure include acetaminophen toxicity, viral hepatitis, alcoholic hepatitis, autoimmune hepatitis, acute fatty liver of pregnancy, Wilson's disease, ischemic hepatitis and hepatic congestion due to right heart failure and Budd–chiari syndrome.
Differentiating Acute Liver Failure from other Diseases
Acute liver failure must be differentiated from other diseases that cause signs and symptoms of jaundice, coagulopathy, and encephalopathy.[1][2][3][4]
| Condition | Differentiating signs and symtoms | Differentiating Tests |
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| Acute hepatits |
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| Cholestasis |
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| Hemolysis |
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Abbreviations:
RUQ= Right upper quadrant of the abdomen, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CT= Computed tomography
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References
- ↑ Escorsell A, Mas A, de la Mata M, Spanish Group for the Study of Acute Liver Failure (2007). "Acute liver failure in Spain: analysis of 267 cases". Liver Transpl. 13 (10): 1389–95. doi:10.1002/lt.21119. PMID 17370334.
- ↑ Bower WA, Johns M, Margolis HS, Williams IT, Bell BP (2007). "Population-based surveillance for acute liver failure". Am J Gastroenterol. 102 (11): 2459–63. doi:10.1111/j.1572-0241.2007.01388.x. PMID 17608778.
- ↑ Kumar R, Shalimar. Bhatia V, Khanal S, Sreenivas V, Gupta SD; et al. (2010). "Antituberculosis therapy-induced acute liver failure: magnitude, profile, prognosis, and predictors of outcome". Hepatology. 51 (5): 1665–74. doi:10.1002/hep.23534. PMID 20196116.
- ↑ Lee WM, Stravitz RT, Larson AM (2012). "Introduction to the revised American Association for the Study of Liver Diseases Position Paper on acute liver failure 2011". Hepatology. 55 (3): 965–7. doi:10.1002/hep.25551. PMC 3378702. PMID 22213561.