Acute liver failure overview: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
Acute liver failure results from the loss of normal function of hepatic tissue which occurs over a short period of time. It results in the loss of the metabolic, secretory, and regulatory effects of the liver cells. This results in the rapid accumulation of toxic substances, which then manifests in the patient as an altered [[sensorium]], [[cerebral edema]], [[hemodynamic]] abnormalities, and even [[multiorgan failure]]. | Acute liver failure results from the loss of normal function of hepatic tissue which occurs over a short period of time. It results in the loss of the metabolic, secretory, and regulatory effects of the liver cells. This results in the rapid accumulation of toxic substances, which then manifests in the patient as an altered [[sensorium]], [[cerebral edema]], [[hemodynamic]] abnormalities, and even [[multiorgan failure]]. | ||
==Causes== | |||
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. | |||
==References== | ==References== | ||
Revision as of 21:20, 28 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Acute liver failure is the appearance of severe complications that occur rapidly after the first signs of liver disease (such as jaundice), and indicates that the liver has sustained severe damage (loss of function of 80-90% of liver cells). The complications that can as a result of acute liver failure are hepatic encephalopathy, cerebral edema, infections, bleeding disorders, and kidney failure.
The definition of acute liver failure is as follows: Evidence of a coagulation abnormality, usually an International Normalized Ratio (INR) > 1.5, and any degree of mental alteration (encephalopathy) in a patient without preexisting cirrhosis and with an illness of <26 weeks duration. [1]
Historical Perspective
Trey and Davidson coined the term fulminant hepatic failure in 1970 to describe this reversible condition of severe liver injury. They described a condition of onset of encephalopathy within 8 weeks of appearance of first symptoms, and an absence of pre-existing liver disease.[2]
Classification
Acute liver failure is classified into three subcategories; hyperacute , acute, and subacute depending upon the time lapsed between the appearance of jaundice, to the development of encephalopathy. In can also be classified into fulminant and subfulminant based upon the time that has lapsed from the start if illness to the onset of encephalopathy.
Pathophysiology
Acute liver failure results from the loss of normal function of hepatic tissue which occurs over a short period of time. It results in the loss of the metabolic, secretory, and regulatory effects of the liver cells. This results in the rapid accumulation of toxic substances, which then manifests in the patient as an altered sensorium, cerebral edema, hemodynamic abnormalities, and even multiorgan failure.
Causes
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.