Acute Liver Failure

2018 ◽  
Vol 39 (05) ◽  
pp. 513-522 ◽  
Author(s):  
Priyanka Rajaram ◽  
Ram Subramanian
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Multiorgan Failure ◽  
Drug Induced ◽  
Detailed Review ◽  
Drug Induced Liver Injury ◽  
The Common ◽  
Organ Dysfunctions ◽  
Common Laboratory

AbstractAcute liver failure (ALF) is a condition that can rapidly progress to multiorgan failure. This article focuses on the diagnosis and management of ALF. We provide a detailed review of the common etiologies of ALF, including acetaminophen overdose, viral hepatitis, drug-induced liver injury, Wilson's disease, and autoimmune hepatitis. The article then addresses how to recognize ALF and reviews the role of common laboratory and imaging tests in establishing this diagnosis. The remainder of the article details the management of hepatic and extrahepatic organ dysfunctions in ALF. The article concludes with a discussion regarding the prognostication of patients with ALF and the criteria for considering liver transplantation.

scholarly journals Acute liver failure in Still’s disease relapse during pregnancy: case report and discussion of a possible trigger role of DILI

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giuseppe Marrone ◽  
Francesco Galati ◽  
Marco Biolato ◽  
Cristopher Oddy ◽  
Sara De Carolis ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Still’S Disease ◽  
Drug Induced ◽  
Early Introduction ◽  
Drug Induced Liver Injury ◽  
Still's Disease ◽  
Systemic Inflammatory Disease

Abstract Background Still's disease is a rare systemic inflammatory disease with frequent but generally mild liver involvement. The most common cause of acute liver failure in western countries is drug-induced liver injury, while it has rarely been reported in subjects suffering from Still’s disease. Case presentation We report a case of a young woman presenting with SD reactivation in pregnancy and acute liver failure after delivery with a possible triggering role of drug induced liver injury. Conclusions The prompt recognition of Still's disease reactivation allowed early introduction of steroid therapy and resolution of the clinical picture. We discuss potential factors precipitating ALF in this case, and implications for the diagnosis and management of such patients.

Acute Liver Failure

2017 ◽  
Author(s):  
Cynthia Wang ◽  
Michelle Y. Braunfeld
Keyword(s):  
Supportive Care ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Intraoperative Monitoring ◽  
Multiorgan Failure ◽  
Anesthetic Management ◽  
Specific Treatment ◽  
Patient Specific ◽  
Drug Induced

Acute liver failure produces widespread physiologic derangements including encephalopathy, coagulopathy, peripheral vasodilation, a systemic inflammatory response, and multiorgan failure. Morbidity is significant, and mortality is 50%. The classification of liver failure and the various etiologies, including viral hepatitis, drug-induced, toxins, and autoimmunity are reviewed here. The multisystem effects of acute liver failure influence all aspects of perioperative care and adequate supportive care during this time is crucial to providing the best possible outcome for the patient. Specific treatment objectives and recommendations are discussed, and the anesthetic management with regard to drug choices, hemodynamic goals, and intraoperative monitoring is reviewed.

scholarly journals PP025—Improving hy’s law definition to better predict the risk of developing acute liver failure in drug-induced liver injury (DILI)

2013 ◽  
Vol 35 (8) ◽  
pp. e25
Author(s):  
M. Robles-Díaz ◽  
C. Stephens ◽  
I. Medina-Cáliz ◽  
A.F. González ◽  
A. González-Jiménez ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Hy’S Law

scholarly journals Correction: Cytokine profiles in acute liver injury—Results from the US Drug-Induced Liver Injury Network (DILIN) and the Acute Liver Failure Study Group

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212394 ◽  
Author(s):  
Herbert L. Bonkovsky ◽  
Huiman X. Barnhart ◽  
David M. Foureau ◽  
Nury Steuerwald ◽  
William M. Lee ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Liver Injury ◽  
Study Group ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Cytokine Profiles ◽  
The Us

Use of Hy's Law and a New Composite Algorithm to Predict Acute Liver Failure in Patients With Drug-Induced Liver Injury

2014 ◽  
Vol 147 (1) ◽  
pp. 109-118.e5 ◽  
Author(s):  
Mercedes Robles–Diaz ◽  
M. Isabel Lucena ◽  
Neil Kaplowitz ◽  
Camilla Stephens ◽  
Inmaculada Medina–Cáliz ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Hy’S Law

scholarly journals Necrotic cell death and suppression of T-cell immunity characterized acute liver failure due to drug-induced liver injury

Cytokine ◽  
2016 ◽  
Vol 86 ◽  
pp. 21-28 ◽  
Author(s):  
Keisuke Kakisaka ◽  
Kojiro Kataoka ◽  
Yuji Suzuki ◽  
Yohei Okada ◽  
Yuichi Yoshida ◽  
...  
Keyword(s):  
Cell Death ◽  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
T Cell Immunity ◽  
Necrotic Cell Death ◽  
Necrotic Cell ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Cell Immunity

Drug-Drug Combinations Can Enhance Toxicity as Shown by Monocyte-Derived Hepatocyte-like Cells From Patients With Idiosyncratic Drug-Induced Liver Injury

2019 ◽  
Vol 171 (2) ◽  
pp. 296-302 ◽  
Author(s):  
Andreas Benesic ◽  
Kowcee Jalal ◽  
Alexander L Gerbes
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Drug Interactions ◽  
Acute Liver Failure ◽  
Causality Assessment ◽  
Drug Combinations ◽  
Positive Interactions ◽  
In Vitro Test ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Abstract Drug-induced liver injury (DILI) is a major cause for acute liver failure and regulatory actions on novel drugs. Individual patient characteristics are the main determinant of idiosyncratic DILI, making idiosyncratic DILI (iDILI) one of the most challenging diagnoses in hepatology. Individual drug-drug interactions might play a role in iDILI. However, the current approaches to iDILI diagnosis are focused on single drugs as causative agents. For the present analysis, 48 patients with acute liver injury who took 2 drugs and who were diagnosed as iDILI were investigated. A novel in vitro test was employed using monocyte-derived hepatocyte-like cells (MH cells) generated from these patients. iDILI diagnosis and causality were evaluated using clinical causality assessment supported by Roussel-Uclaf Causality Assessment Method. In 13 of these 48 patients (27%), combinations of drugs increased toxicity in the MH test when compared with the single drugs. Interestingly, whereas in 24 cases (50%) drug-drug combinations did not enhance toxicity, in 11 cases (23%) only the combinations caused toxicity. The incidence of severe cases fulfilling Hy’s law was higher in patients with positive interactions (57% vs 43%; p = .04), with acute liver failure occurring in 40% versus 8% (p = .01). The most common drug combinations causing increased toxicity were amoxicillin/clavulanate (8 of 9 cases) and diclofenac in combination with steroid hormones (4 of 9 cases). Drug-drug interactions may influence the incidence and/or the severity of idiosyncratic DILI. MH cell testing can identify relevant drug-drug interactions. The data generated by this approach may improve patient safety. Study identifier ClinicalTrials.gov NCT 02353455.

scholarly journals Drug Induced Hepatotoxicity – An Ongoing Challenge

2020 ◽  
Vol 10 (3) ◽  
pp. 244-248
Author(s):  
Mehr Fatima ◽  
Syed Zaidi
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Liver Damage ◽  
Obese People ◽  
Drug Induced ◽  
Pharmacological Agents ◽  
Drug Induced Liver Injury ◽  
High Incidence ◽  
Inflammatory Drugs

Drug induced liver injury is one of the main factor of liver failure and acute liver damage world wide with high incidence in western countries. Liver injury can be intrinsic (dose dependant) or idiosyncratic (dose independent). However idiosyncratic type is considered to be mainly responsible for drug induced liver damage. Binding of reactive metabolites of drugs to tissue proteins and oxidative stress is the possible cellular mechanism involved in this process. Moreover, some antibiotics, anti-epileptics, nonsteroidal anti-inflammatory drugs etc are more likely to induce liver damage in high risks groups that includes females, elderly and obese people. HLA halotype and variation in protein expression also plays an important role in this context. Various studies are available regarding clinical features, histopathological features, diagnosis and management related to antibiotics and acetaminophen induced liver damage. N acetylcysteine is commonly available antidote for drug induced hepatic damage. Role of other pharmacological agents as an antidote requires further studies. However, liver transplantation should be considered with drug induced lethal liver failure

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