Acute Liver Failure

Acute Liver Failure

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Overview

Acute liver failure is a rare medical condition which occurs most often in patients without pre-existing liver disease. This usually happens right after an overdose of medicine or poisoning. However, chronic liver failure occurs over a long stretch of time.

What are the symptoms of acute liver failure?

  • Yellowing of the eyes and skin
  • Pain in your upper right abdomen
  • Swelling in the abdominal
  • Nausea and vomiting
  • Feeling of being unwell (malaise)
  • Confusion
  • Sleepiness
  • Tremors

What causes acute liver failure?

Acute liver failure occurs when the cells of the liver are damaged significantly and are unable to function. Potential causes include:

  • Medicine overdose: Taking excessive medicine without the doctor’s approval may lead to liver issues. Consulting your doctor about this and taking treatment for an overdose may prevent liver failure.
  • Effect of prescribed medications: Some medications, like antibiotics, nonsteroidal anti-inflammatory drugs, and anticonvulsants, can cause acute liver failure.
  • Herbal supplements: The use of certain herbal drugs have been linked with acute liver failure.
  • Toxins: Toxins such as carbon tetrachloride (found in the refrigerator, solvents of varnishes, etc.) can cause acute liver failure.
  • Autoimmune disease: Liver failure can occur as a result of autoimmune hepatitis. It is a disease where your immune system attacks liver cells, leading to injury and inflammation.
  • Hepatitis and other viruses: Hepatitis A, B, and E, and other viruses like herpes simplex virus, Epstein-Barr virus, cytomegalovirus can cause acute liver failure.
  • Vascular disease: Vascular diseases like Budd-Chiari syndrome may cause blockages in the veins of the liver leading to acute liver failure.
  • Metabolic disease: Some rare metabolic diseases like Wilson's disease and acute fatty liver of pregnancy infrequently result in acute liver failure.
  • Cancer: Cancer which either originates in or spreads to the liver can cause the liver to fail.
  • Shock: Sepsis and shock can severely impair the liver blood flow, causing liver failure.
  • Heatstroke: Indulging in extreme physical activity in a hot environment may trigger acute liver failure.

What are the risk factors of acute liver failure?

  • Certain injections and diseases or infections like hepatitis, Wilson disease, and herpes simplex virus
  • Excessive consumption of alcohol
  • Having poor blood flow to the liver

How is acute liver failure diagnosis?

Based on the observations from the physical examination, he will suggest some tests that will help confirm the diagnosis:

  • Blood tests: Various blood tests may help in accessing how the liver is working. In patients with acute liver failure, a prothrombin test (measures the blood clotting time) is recommended as these patient’s blood takes a longer time to clot than normal.
  • Ultrasound: This test is done using sound waves to make a detailed picture and gives information about any abnormality. If this test shows any abnormality, your doctor may recommend imaging tests like CT scan and MRI.
  • CT scan: This test uses a special dye medium that helps with a clear image of the body parts from different angles. It can help in seeing detailed images of soft tissue and blood vessels. CT scan helps in finding any abnormality related to the liver.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields to produce detailed body images.
  • Biopsy: In this procedure, a sample tissue is taken from the site and sent to the laboratory to look for any abnormality. There are various ways to doing a biopsy:
  • Fine needle aspiration (FNA): Small amount of tissue is removed with the help of the fine needle.
  • Core biopsy: This procedure is similar to FNA. However, instead of a fine needle, a thick needle is used to remove small cylinder-shaped samples.
  • Laparoscopic biopsy: In this procedure, a small incision is made in the abdomen, and then a thin tube light and camera are inserted into the stomach to look for abnormality.
  • Surgical biopsy: The process of removal of tissue during the operative procedure is known as a surgical biopsy.

What are the treatment options available for acute liver failure?

In acute liver failure, your doctor may treat the damaged liver; however, in many cases, treatment focuses on controlling the complications and giving your liver time to heal. Treatment for acute liver failure depends upon treating the causative factor; this may include:

  • Medications to reverse poisoning: Acute liver failure caused due to overdose of certain medication is treated where it helps in reversing the poisoning caused by the medicine. Your doctor will work to control the signs and symptoms you're experiencing and try to prevent complications caused due to acute liver failure.
  • Managing hepatitis: If viral hepatitis is the cause of your acute liver failure, your doctor may prescribe you some medicine depending on the type of viral hepatitis which is causing the failure. If autoimmune hepatitis is the causative factor for your liver failure, your doctor can treat you with steroids.
  • Unknown cause: If the doctor is unable to find the reason for acute liver failure, he may suggest a liver biopsy. This will give more information and help the doctor in determining the treatment.
  • Liver transplant: If you are not responding to treatment, then you may need a liver transplant. The doctor will examine you and may recommend a certain test that will help him in identifying if you are a good candidate for a liver transplant. Once he is sure, you will be approved for the procedure, and he will guide you in this.

Tips for prevention

Below are some tips that help in reducing the risk of acute liver failure by taking care of your liver.

  • Follow instructions on medications: Avoid taking any excessive medicine. It is suggested to always follow a doctor’s prescription.
  • Tell your doctor about all your medicines: Some herbal medicines and over-the-counter can interfere with certain prescribed drugs.
  • Drink alcohol in moderation: It is always advisable to limit alcohol consumption.
  • Avoid risky behavior: Avoid risky practices like sharing a needle, having unprotected sex, etc. If you are planning to have tattoos or body piercings, ensure to choose a place that offers safe practices.
  • Get vaccinated: Get yourself vaccinated for hepatitis A and hepatitis B as this reduces the risk of liver failure.
  • Get medical attention if you’re exposed to blood: Immediately consult your doctor if you come into contact with someone else’s blood.
  • Take care with aerosol sprays: Whenever you use an aerosol cleaner, ensure the room is ventilated or wear a mask. Take similar protective measures while spraying insecticides, fungicides, paint, and other toxic chemicals. Follow instructions given on the product carefully.
  • Maintain a healthy weight: Being obese can lead to a condition known as non-alcoholic fatty liver disease, which may include fatty liver, cirrhosis, and hepatitis.

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