Acute Liver Failure (ALF)

Acute (< 24w) hx liver dysfunction (encephalopathy, elevated INR) in someone without previously known cirrhosis or liver disease.

Etiology

  • Ischemic injury
  • Acetaminophen toxicity
  • Drug induced liver injury
  • Acute Budd-Chiari (hepatic vein thrombosis)
  • Sepsis with impaired perfusion
  • Acute Wilson's disease
  • Acute viral hepatitis (A, B, E)
  • Autoimmune hepatitis
  • Infiltrative disease from cancer
  • Toxin exposure (e.g. mushrooms, drugs of abuse, other)

Symptoms

  • Confusion
  • Jaundice

Physical Exam Findings

  • Jaundice
  • Icterus
  • Ascites
  • Bleeding
  • Tachycardia, hypotension, signs of severe illness
  • Confusion, lethargy