Acute liver failure is when the liver stops functioning suddenly (in days or weeks). Acute liver failure does not occur as frequently as the chronic liver failure. As it is a very serious condition, where additionally complications can occur, hospitalization is required.

 

Symptoms

Symptoms of acute liver failure are those of severe acute liver injury. The common symptoms are:

  • period of fatigue
  • nausea
  • poor appetite
  • pain in the right upper part of the abdomen
  • dark urine 
  • jaundice 
  • symptoms of hepatic failure like swelling, peripheral edema and coagulopathy

The diagnosis of acute liver failure is based on clinical symptoms of hepatic encephalopathy. The first symptoms of hepatic encephalopathy may be subtle and those are:  change in personality, forgetfulness, somnolence, irrational or violent behavior.

 

Causes

The main causes of acute liver failure are:

  • Viruses – hepatitis B, hepatitis C (rare), hepatitis E (if contracted during pregnancy), hepatitis A (rare), cytomegalovirus, Epstein-Barr virus, herpes simplex virus, human herpes virus 6, parvovirus B19, varicella-zoster virus, viruses that cause hemorrhagic fever
  • Acetaminophen is the most common cause when taken in one large dose or higher doses than recommended
  • Toxins, for e.g. in poisonous wild mushrooms (Amanita phalloides)
  • Existing liver disease
  • Chronic alcohol use
  • Use of drugs
  • Herbal supplements (kava, ephedra, pennyroyal)
  • Autoimmune hepatitis

Less common causes are:

  • Vascular disorders – hepatic vein thrombosis (Budd-Chiari syndrome), ischemic hepatitis, portal vein thrombosis, and hepatic sinusoidal obstruction syndrome (also called hepatic veno-occlusive disease), which is sometimes drug- or toxin-induced
  • Metabolic disorders – acute fatty liver of pregnancy, HELLP syndrome (hemolysis, elevated liver function tests, and low platelets), Reye syndrome, and Wilson disease
  • Cancer – that begins or spreads in the liver
  • Heatstroke
  • Sepsis

 

Complications

The complications of acute liver failure are:

  • Infections, especially in the blood and the respiratory and urinary tracts
  • Kidney failure, very frequent in cases of acetaminophen overdose
  • Bleeding in the gastrointestinal tract that may be difficult to control
  • Cerebral edema – when fluids accumulate in the brain occupying its space and the brain may be left without oxygen

 

 

Prevention

Prevention of acute liver failure means that you can take care of your health and not risk of developing this condition. You can:

  • Conscientiously use medications like acetaminophen as recommended
  • drink alcohol in normal quantity
  • avoid eating wild mushrooms
  • avoid over-eating and be overweight
  • ask your doctor if there are any interactions with other medications you may use
  • avoid sharing needles, or razors, toothbrushes