Sa1014 The Clinical Features and Prognosis of Acute Liver Failure Due to Ischemic Liver Damage

Introduction: In the present study, etiology, important clinical features, management and outcome of acute liver failure in children admitted in Pediatric Intensive Care Unit (PICU) of BURDWAN MEDICALCOLLEGE, WB are studied. Aims and objectives:To study different clinical features among those children having acute liver failure. I. To study the management and outcome of those children with acute liver failure in the Pediatric Intensive Care Unit. Material and methods: Pediatric Intensive Care Unit of BURDWAN MEDICALCOLLEGE, WB. 1 Year [December 2019 to November 2020]. Patients from 3months of age to 12years of age are eligible for enrolment if they meet the following criteria. Conclusion: Present study showed that cerebral edema was signicantly associated with mortality whereas AKI and spontaneous bacterial peritonitis were not signicantly related with mortality. Mean TSB and Prothrobin Time were higher but mean serum albumin was lower in those cases that had died.

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COVID-19: a fatal case of acute liver failure associated with SARS-CoV-2 infection in pre-existing liver cirrhosis

BMC Infectious Diseases ◽

10.1186/s12879-021-06605-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jana Ihlow ◽

Alexander Seelhoff ◽

Victor M. Corman ◽

Achim D. Gruber ◽

Simon Dökel ◽

...

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Liver Damage ◽

Cathepsin L ◽

Fatal Case ◽

Clinical Signs ◽

Angiotensin Converting Enzyme 2 ◽

Severe Liver Damage ◽

Severe Jaundice ◽

Transmembrane Serine Protease

Abstract Background The detection of severe acute respiratory syndrome coronavirus (SARS-CoV-2) is challenging, particularly in post-mortem human tissues. However, there is increasing evidence for viral SARS-CoV-2 manifestation in non-respiratory tissues. In this context, it is a current matter of debate, whether SARS-CoV-2 shows hepatotropism. Case presentation Here, we report a case of an 88-year-old women with massive SARS-CoV-2 viremia, severe jaundice and clinical signs of an acute hepatitis, who died within a few days from an acute liver failure without showing any clinical signs of pneumonia. Autopsy revealed a severe chronic and acute liver damage with bile duct infestation by SARS-CoV-2 that was accompanied by higher expressions of angiotensin-converting enzyme-2 (ACE2), Cathepsin L and transmembrane serine protease 2 (TMPRSS2). Conclusion Our findings indicate an enhanced biliary susceptibility to viral infection with SARS-CoV-2, that might have resulted from pre-existing severe liver damage. Furthermore, our findings emphasize the differential diagnosis of coronavirus disease 2019 (COVID-19)-associated liver failure in the clinical setting of an inexplicable jaundice.

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The clinical features and outcomes of acute liver failure associated with dengue infection in adults: a case series

The Brazilian Journal of Infectious Diseases ◽

10.1016/j.bjid.2012.09.007 ◽

2013 ◽

Vol 17 (2) ◽

pp. 164-169 ◽

Cited By ~ 29

Author(s):

Soek-Siam Tan ◽

Mohamad Adam Bujang

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Clinical Features ◽

Dengue Infection ◽

Case Series

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Persistence of Parvovirus B19 in liver from transplanted patients with acute liver failure

Future Microbiology ◽

10.2217/fmb-2019-0224 ◽

2020 ◽

Vol 15 (5) ◽

pp. 307-317 ◽

Cited By ~ 1

Author(s):

Arthur DR Alves ◽

Juliana G Melgaço ◽

Rita de Cássia NC Garcia ◽

Jessica V Raposo ◽

Vanessa S de Paula ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Failure ◽

Acute Liver Failure ◽

Liver Damage ◽

Parvovirus B19 ◽

Transcript Expression ◽

Mrna Transcript ◽

Serological Tests ◽

Infected Liver

Aim: In this study, we investigated the presence of B19V in liver tissues from patients with acute liver failure (ALF) and evaluated the viral activity in infected liver. Methods: Serum and liver samples from 30 patients who underwent liver transplantation for ALF were investigated for B19V infection by real-time PCR, serological tests and examination of B19V mRNA (transcript) expression in the liver. Results: The serum and liver samples from seven patients were B19V DNA positive (103–105 copies/ml). Most of them presented detectable anti-B19V IgG, indicating persistent infection. B19V mRNA was detected in all patients, demonstrating intra-hepatic replication. Conclusion: B19V infection of the liver during the course of non-A-E ALF suggested a role of B19V, which produced the worst outcome in co-infected patients and in patients with cryptogenic ALF, in liver damage.

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Liver stiffness measured by acoustic radiation force impulse elastography reflects the severity of liver damage and prognosis in patients with acute liver failure

Hepatology Research ◽

10.1111/hepr.12389 ◽

2014 ◽

Vol 45 (5) ◽

pp. 571-577 ◽

Cited By ~ 11

Author(s):

Hidekatsu Kuroda ◽

Keisuke Kakisaka ◽

Takayoshi Oikawa ◽

Mio Onodera ◽

Yasuhiro Miyamoto ◽

...

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Liver Damage ◽

Acoustic Radiation ◽

Liver Stiffness ◽

Radiation Force ◽

Acoustic Radiation Force ◽

Acoustic Radiation Force Impulse

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Clinical features, laboratory characteristics and outcome of patients with drug-induced acute liver failure

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20191168 ◽

2019 ◽

Vol 6 (2) ◽

pp. 515

Author(s):

Tauseef Nabi ◽

Nadeema Rafiq ◽

Imran Jamil ◽

Quratul Ain Arifa

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Hospital Stay ◽

Clinical Features ◽

Geographical Area ◽

Length Of Hospital Stay ◽

Medical Emergency ◽

Rapid Progression ◽

Middle Aged ◽

Drug Induced

Background: Acute liver failure (ALF) is a rare medical emergency. Its rapid progression and high mortality demand early diagnosis and expert management. Drug-induced ALF (DI-ALF) remains the uncommon cause of ALF in India. Clinical and etiological profile varies with geographical area and time. A prospective study of DI-ALF was carried with the aim to determine the clinical features, laboratory characteristics, outcome and hospital course.Methods: A total of 15 patients with a diagnosis of DI-ALF were included in the study. The variables evaluated were demographic, signs and symptoms, biochemical parameters [bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), internal normalization ratio (INR) etc.], outcome and course during hospitalization.Results: Out of 15 DI-ALF patients, 12 had Anti-tuberculosis therapy (ATT) induced ALF and 3 patients had ayurvedic induced ALF. Majority of the patients were females (73.3%) and middle-aged (42.60±14.30 years). Coma grade at the time of admission showed that majority of patients (66.8%) had grade I and II encephalopathy. Depending on the pattern of liver injury, hepatocellular pattern was most common (53.3%) followed by mixed and cholestatic pattern. 40% of patients died with DI-ALF complications of which ATT induced ALF contributed 41.7%. Mean AST was more increased as compared to ALT. Development of ascites (P = 0.030) and mannitol use (P = 0.025) was significantly more common in non survived group than survived group. Length of hospital stay was significantly more in non survived group than survived group (P = 0.009).Conclusions: ATT was the class of drugs most frequently associated with DI-ALF. DI-ALF disproportionately affected middle-aged women. Most DILI ALF patients had hepatocellular injury pattern. 40% of patients died with DI-ALF complications. Development of ascites, mannitol use and length of hospital stay was significantly more in non survived group than survived group.

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Effects of larazotide acetate, a tight junction regulator, on the liver and intestinal damage in acute liver failure in rats

Human & Experimental Toxicology ◽

10.1177/09603271211058882 ◽

2021 ◽

pp. 096032712110588

Author(s):

Ali Riza Caliskan ◽

Mehmet Gul ◽

Ismet Yılmaz ◽

Baris Otlu ◽

Nuray Uremis ◽

...

Keyword(s):

Epithelial Cells ◽

Liver Failure ◽

Acute Liver Failure ◽

Liver Damage ◽

Light And Electron Microscopy ◽

Intestinal Damage ◽

Intestinal Histology ◽

Oral Gavage ◽

Significant Difference ◽

Serum Ammonia

Background and Aim The epithelial cells are the strongest determinants of the physical intestinal barrier. Tight junctions (TJs) hold the epithelial cells together and allow for selective paracellular permeability. Larazotide acetate (LA) is a synthetic octapeptide that reduces TJ permeability by blocking zonulin receptors. In this study, we aimed to investigate the effects of LA, a TJ regulator, on the liver and intestinal histology in the model of acute liver failure (ALF) in rats. Materials and Methods The thioacetamide (TAA) group received intraperitoneal (ip) injections of 300 mg/kg TAA for 3 days. The TAA+LA(dw) (drinking water) group received prophylactic 0.01 mg/mL LA orally for 7 days before the first dose of TAA. The LA(dw) group received 0.01 mg/mL LA orally. The TAA + LA(g) (gavage) group received prophylactic 0.01 mg/mL LA via oral gavage for 7 days before the first dose of TAA. The LA(g) group received 0.01 mg/mL LA via oral gavage. While liver tissue was evaluated only with light microscopy, intestinal samples were examined with light and electron microscopy. Results Serum ammonia, AST, and ALT levels in the TAA group were significantly higher than in control groups (all p < 0.01). Serum ALT levels in the TAA + LA(dw) group were significantly lower than in the TAA group ( p < 0.05). However, serum ammonia and ALT levels did not differ between the TAA and other groups. Serious liver damage in the TAA group was accompanied by marked intestinal damage. There was no significant difference between the TAA and TAA + LA(dw) groups and TAA and TAA + LA(g) groups for liver damage scores. However, intestinal damage scores significantly decreased in the TAA + LA(dw) group compared to the TAA group. In the TAA + LA(dw) group, fusion occurred between the surface epithelial cells of neighboring villi and connecting regions formed as epithelial bridges between the villi. Conclusion Our findings suggest that LA reduced intestinal damage by acting on TJs in the TAA-induced ALF model in rats.

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