Acute Liver Failure
Acute Liver Failure
Acute liver failure is a rapid loss of liver function that occurs within days or weeks, usually in a person without previous liver disease. Common causes include hepatitis viruses or drugs like acetaminophen. Unlike chronic liver failure, which develops gradually, acute liver failure is rare. This condition, also known as fulminant hepatic failure, can lead to severe complications such as bleeding and increased pressure in the brain. It is a medical emergency that requires immediate hospitalization.
Treatment can sometimes reverse acute liver failure, depending on its cause. However, in many cases, a liver transplant might be necessary.
Acute Liver Failure Symptoms:
- Yellowing of the skin and eyes (jaundice)
- Pain in the upper right abdomen
- A swollen belly (ascites)
- Nausea
- Vomiting
- General malaise
- Disorientation or confusion
- Sleepiness
- Breath with a musty or sweet odor
- Tremors
Liver Failure Treatment
Medication: Acetylcysteine can treat acute liver failure resulting from an acetaminophen overdose, but it must be administered promptly. There are also medications available to counteract the effects of poisonous mushrooms or other toxins.
Supportive Care: If a virus is the cause of liver failure, a hospital can manage your symptoms until the virus runs its course. In such cases, the liver may sometimes recover on its own.
Liver Transplant: This procedure may involve receiving a liver from a deceased donor or a portion of a liver from a live donor. A healthy liver portion will grow to its full size after transplantation.
Surgery: This involves removing the diseased portion of your liver, known as a liver resection or hepatectomy. The remaining healthy part of your liver will regenerate.
Treating Liver Failure in People with Alcohol Addiction
Alcohol-related liver disease (also called alcoholic liver disease) is liver damage caused by excessive alcohol consumption, usually over many years. Symptoms typically mirror those of chronic liver disease:
- Weight loss
- Jaundice
- Swelling in the stomach and ankles
- Confusion and fatigue
- Passing blood in stool or vomiting blood
Every time the liver processes alcohol, some liver cells die. Although some regenerate, excessive alcohol can cause permanent damage.
The primary treatment is to stop drinking, which can be challenging for those addicted to alcohol. Medications like benzodiazepines (e.g., Valium) or psychological counseling may be provided to assist with withdrawal. Many people seek help from rehab centers or support groups like Alcoholics Anonymous.
Other treatments, such as liver transplants, are only options once you stop drinking. Maintaining a proper diet is also important, as many individuals with alcohol-related liver disease do not eat healthily. Avoid salty foods to reduce body swelling.
Acute Liver Failure Causes
Acute liver failure occurs when liver cells are significantly damaged and can no longer function. Potential causes include:
- Acetaminophen overdose: Taking too much acetaminophen (Tylenol) is the most common cause in the U.S. Acute liver failure can result from a single large dose or repeated higher-than-recommended doses.
- Prescription medications: Some antibiotics, nonsteroidal anti-inflammatory drugs, and anticonvulsants can cause acute liver failure.
- Herbal supplements: Certain herbal supplements, like kava, ephedra, skullcap, and pennyroyal, are linked to acute liver failure.
- Hepatitis and other viruses: Hepatitis A, B, and E, along with viruses like Epstein-Barr, cytomegalovirus, and herpes simplex, can cause acute liver failure.
- Toxins: Poisonous wild mushrooms (e.g., Amanita phalloides) and industrial chemicals (e.g., carbon tetrachloride) can lead to acute liver failure.
- Autoimmune disease: Autoimmune hepatitis, where the immune system attacks liver cells, can cause liver failure.
- Vascular diseases: Conditions like Budd-Chiari syndrome can cause blockages in liver veins, leading to liver failure.
- Metabolic diseases: Rare conditions like Wilson’s disease and acute fatty liver of pregnancy can cause acute liver failure.
- Cancer: Cancer that begins in or spreads to the liver can cause liver failure.
- Shock and heat stroke: Severe infections (sepsis), shock, and extreme physical activity in hot environments can trigger acute liver failure.
Acute Liver Failure Complications
Acute liver failure can lead to complications such as:
- Cerebral edema: Excess fluid in the brain, causing pressure, disorientation, severe mental confusion, and seizures.
- Bleeding disorders: Insufficient clotting factors, leading to uncontrollable bleeding, particularly in the gastrointestinal tract.
- Infections: Increased susceptibility to blood, respiratory, and urinary tract infections.
- Kidney failure: Often follows liver failure, especially after acetaminophen overdose.
Prevention
To reduce the risk of acute liver failure:
- Follow medication instructions and do not exceed recommended dosages.
- Drink alcohol in moderation, if at all.
- Avoid risky behaviors, such as using illicit intravenous drugs and sharing needles.
- Avoid contact with others’ blood and body fluids.
- Do not eat wild mushrooms.
- Use aerosol sprays and toxic chemicals in well-ventilated areas and follow safety instructions.
FAQ?
Symptoms include jaundice, abdominal pain and swelling, confusion, sleepiness, and bleeding easily.
Diagnosis involves blood tests to assess liver function, imaging studies (like ultrasound or CT scan) to evaluate liver condition, and sometimes a liver biopsy to determine the cause and severity.
Treatment may involve supportive care in a hospital setting, such as medications to manage symptoms, monitoring for complications like brain swelling, and liver transplantation in severe cases where liver function does not recover.