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Acute Liver Failure

Diseases and Conditions Acute Liver Failure
Overview Types Causes & Risk Factors Symptoms Preventions Treatment
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Overview

Acute liver failure, also known as fulminant hepatic failure, is a rare and life-threatening condition characterized by the rapid deterioration of liver function in a matter of days or weeks. It can be caused by various factors, including viral infections, drug overdoses, autoimmune disorders, or toxic reactions to medications or chemicals. As the liver fails, it struggles to perform its vital functions, such as detoxifying the blood, producing proteins, and aiding digestion. Consequently, individuals with acute liver failure may experience symptoms like jaundice (yellowing of the skin and eyes), abdominal pain, confusion, and bleeding tendencies. Prompt medical attention is essential, often requiring hospitalization, intensive care, and, in severe cases, liver transplantation as the ultimate life-saving measure. The prognosis for acute liver failure can be highly unpredictable, and successful management depends on early diagnosis and appropriate treatment tailored to the underlying cause of the condition.

ALF demands immediate medical attention and intervention. In this comprehensive article, we will unravel the complexities of ALF, covering its causes, risk factors, types, symptoms, diagnosis, prevention strategies, treatment options, and guidance on when to seek medical help.

Types of Acute Liver Failure

ALF can be categorized into three main types:

1) Hyperacute ALF: Characterized by rapid onset of symptoms and a high risk of complications.

2) Acute-on-Chronic ALF: Occurs in individuals with pre-existing liver disease, where a sudden insult leads to acute deterioration.

3) Subacute ALF: Progresses more slowly than hyperacute ALF, allowing for some time for medical intervention.

Causes of Acute Liver Failure

ALF can be triggered by various factors, including:

  • Viral Infections: Hepatitis viruses, especially hepatitis B and C, can lead to ALF.
  • Drug-Induced Liver Injury: Some medications, when used improperly or in high doses, can harm the liver.
  • Toxic Exposures: Exposure to certain chemicals, toxins, or mushrooms can result in ALF.
  • Autoimmune Liver Diseases: Conditions like autoimmune hepatitis can lead to liver failure.

Risk Factors of Acute Liver Failure

Several factors may increase the risk of developing ALF:

  • Age: ALF can affect individuals of all ages, but it may be more common in younger people.
  • Medications: Some medications, particularly acetaminophen (paracetamol), can cause liver damage if not used as directed.
  • Viral Hepatitis: Chronic viral hepatitis infections can progress to ALF.
  • Alcohol Abuse: Excessive alcohol consumption can harm the liver over time, potentially leading to ALF.

Symptoms of Acute Liver Failure

Signs and symptoms of acute liver failure may include:
1. Yellowing of your skin and eyeballs (jaundice): This is a common symptom of liver disease. Jaundice is caused by the buildup of bilirubin, a dark yellow-brown substance made in the liver. Normally, the liver releases bilirubin into your intestines. But if the liver is damaged, bilirubin can leak into the blood and collect under the skin, causing your skin and eyes to look yellow.
2. Pain in your upper right abdomen: This is often due to the liver becoming swollen or inflamed, which can cause discomfort in the upper right part of your abdomen.
3. A swollen belly (ascites): Ascites is the buildup of fluid in the space between the lining of the abdomen and the organs. This often occurs when the liver is not working properly.
4. Nausea and vomiting: These are common symptoms of liver disease. They can be caused by a variety of factors, including changes in metabolism and toxins that build up in the blood when the liver is damaged.
5. A general sense of feeling unwell (malaise): This can include fatigue, weakness, and a decrease in appetite. It’s a non-specific symptom that can occur with many types of illness, including liver disease.
6. Disorientation or confusion: Known as hepatic encephalopathy, this can occur when the liver is not able to remove toxins from the blood. These toxins can then build up in the brain, causing cognitive problems like disorientation and confusion.
7. Sleepiness: This can also be a result of hepatic encephalopathy. The buildup of toxins in the brain can lead to excessive sleepiness.
8. Breath may have a musty or sweet odor: This is known as fetor hepaticus, a breath odor resulting from increased dimethyl sulfide due to severe portal-systemic shunting. It’s a sign of severe liver disease.
9. Tremors in hands (asterixis): This is a flapping tremor of the hands. It’s another sign of hepatic encephalopathy.

Preventions of Acute Liver Failure

Preventing ALF involves avoiding risky behaviors such as excessive alcohol consumption and the misuse of medications. Vaccinations for hepatitis A and B can also be protective.

Diagnosis of Acute Liver Failure

Diagnosing ALF typically involves:

  • Blood Tests: Assessing liver function and checking for elevated liver enzymes and bilirubin.
  • Imaging: Imaging tests like ultrasound or CT scans may be used to evaluate liver health.
  • Biopsy: In some cases, a liver biopsy may be needed to determine the cause and extent of liver damage.

Treatment for Acute Liver Failure

Treatment of ALF aims to manage the underlying cause, support liver function, and prevent complications. This may involve medications, supportive care, and, in severe cases, liver transplantation.

 

When to seek medical attention ?

If you experience symptoms such as jaundice, fatigue, nausea, abdominal pain, or confusion, seek immediate medical attention. Early diagnosis and treatment can significantly impact the outcome and recovery from ALF.