ACUTE LIVER FAILURE

Definition

Acute liver failure occurs when your liver rapidly loses its ability to function. More commonly, liver failure develops slowly over the course of years. But in acute liver failure, liver failure develops in a matter of days.

Acute liver failure can cause many complications, including excessive bleeding and increasing pressure in the brain. Another term for acute liver failure is fulminant hepatic failure.

Symptoms

Signs and symptoms of acute liver failure may include:

• A yellowing of your skin and eyeballs (jaundice)
• Pain in the upper right area of your abdomen
• Nausea
• Vomiting
• A general sense of not feeling well
• Difficulty concentrating
• Disorientation or confusion
• Sleepiness

Causes

Acute liver failure occurs when liver cells are damaged significantly and no longer able to function. Acute liver failure has many potential causes, including:

• Acetaminophen overdose. Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the United States. Acute liver failure can occur if you take a very large dose of acetaminophen all at once, or it can occur if you take higher-than-recommended doses every day for several days, especially in people with chronic liver disease.
• Prescription medications. Some prescription medications, including antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants, can cause acute liver failure.
• Herbal supplements. Herbal drugs and supplements, including kava, ephedra, skullcap and pennyroyal, have been linked to acute liver failure.
• Hepatitis and other viruses. Hepatitis A, hepatitis B and hepatitis E can cause acute liver failure. Other viruses that can cause acute liver failure include Epstein-Barr virus, cytomegalovirus and herpes simplex virus.
• Toxins. Toxins that can cause acute liver failure include the poisonous wild mushroom Amanita phalloides, which is sometimes mistaken for edible species.
• Autoimmune disease. Liver failure can be caused by autoimmune hepatitis — a disease in which your immune system attacks liver cells, causing inflammation and injury.
• Diseases of the veins in the liver. Vascular diseases, such as Budd-Chiari syndrome, can cause blockages to form in the veins of the liver and lead to acute liver failure.
• Metabolic disease. Rare metabolic diseases, such as Wilson's disease and acute fatty liver of pregnancy, infrequently cause acute liver failure.
• Cancer. Cancer that begins in your liver or cancer that spreads to your liver from other places in your body can cause your liver to fail.

Prevention

Reduce your risk of acute liver failure by taking care of your liver. Try to:

• Follow instructions on medications. If you take acetaminophen or other medications, check the package insert for instructions on the recommended dosage and don't exceed that dosage.
• Tell your doctor about all your medicines. Tell your doctor about over-the-counter and herbal medicines that you're taking. These can interfere with prescription drugs you're taking.
• Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to no more than one drink a day for women and no more than two drinks a day for men.
• Avoid risky behavior. Get help if you use illicit intravenous drugs. Don't share needles used to inject drugs. If you choose to have sex, use condoms. If you choose to have tattoos or body piercings, be careful about cleanliness and safety when it comes to selecting a shop.
• Get vaccinated. If you're at increased risk of contracting hepatitis, if you've already been infected with any form of the hepatitis virus or if you have chronic liver disease, talk to your doctor about getting the hepatitis B vaccine. A vaccine is also available for hepatitis A.
• Avoid contact with other people's blood and body fluids.Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids. It's also possible to become infected by sharing razor blades or toothbrushes.
• Don't eat wild mushrooms. It can be difficult to distinguish an edible mushroom from a poisonous one.
• Take care with aerosol sprays. When you use an aerosol cleaner, make sure the room is ventilated, or wear a mask. Take similar protective measures when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer's instructions.
• Watch what gets on your skin. When using insecticides and other toxic chemicals, cover your skin with gloves, long sleeves, a hat and a mask.
• Choose a healthy diet. Choose a plant-based diet with a variety of fruits and vegetables. Limit high-fat foods.
• Maintain a healthy weight. Obesity can cause a condition called nonalcoholic fatty liver disease, which may include fatty liver, hepatitis and cirrhosis.