Causes and risk factors:
Viral infection, Hepatitis A and E is the most common cause of acute liver failure. Immuncompromised people are more prone for developing infection. Radiation treatment used for cancer increases the risk for developing liver failure. Although rare infection by herpes simplex virus, cytomegalovirus and parvovirus’s can also lead to acute liver failure. Acute liver failure induced by drugs is also common cause accounting for 50% cases of liver failure. Certain metabolic diseases, Wilson’s disease, neoplastic infiltration or respiratory failure also predispose acute liver failure.
Clinical presentations:
Depending upon the duration liver failure is classified as hyperacute, acute and subacute type. Any liver injury less than 20 weeks causing failure is known as acute liver failure. The symptoms manifest from few days to months after injury. The patient experience pain or discomfort in the upper right quadrant of the abdomen. On examination by the doctor liver becomes greatly palpable. Swelling exists. Yellowish discoloration of skin, mucus membrane and sclera (Jaundice) occurs. Patient suffers from nausea, vomiting, loss of appetite and fatigue. Changes at the mental level are also seen. Rise in blood pressure, pulse, along with bleeding underneath the skin, bleeding tendency along with encephalopathy (INR ≥1.5) is seen. Person can land up in coma.
Diagnosis and investigations:
Diagnosis is done on the basis of symptoms narrated by the patient and the palpation of the abdomen carried out by the doctor. Blood test for IgM antibodies, bleeding and clotting time along with prothroimbin time test is diagnostic. Certain other investigations which are recommended are urine analysis (Urine Routine and urine culture), complete blood count and liver function test. Liver ultrasound or CT scan are the other investigations which can be done.
Treatment:
Acute liver failure is a fatal disease and needs prompt treatment. Treating the underlying cause is the main line of treatment. The person is hospitalized and is kept under close monitoring. IV fluids are started; N acetylcystine therapy can improve the outcome. Symptomatic treatment, correction of coagulation and treatment of infection is taken care of .Liver transplantation is an important treatment option in severe cases.
Other modes of treatment:
The other modes of treatment can also be effective in treating liver failure. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms.
