Plasmapheresis in Acute Liver Failure

1986 ◽  
Vol 9 (6) ◽  
pp. 433-438 ◽  
Author(s):  
J.G. Freeman ◽  
K. Matthewson ◽  
C.O. Record
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatic Failure ◽  
Serum Bilirubin ◽  
Hepatic Coma ◽  
Acute Hepatic Failure ◽  
Plasma Ammonia ◽  
Coma Grade ◽  
Better Than

A series of 9 patients with acute hepatic failure and Grade IV hepatic coma received daily plasmapheresis until they recovered or death ensued. Of the nine, seven (77%) showed an improvement in coma grade and five (55%) survived to leave hospital. Plasmapheresis significantly decreased serum bilirubin, asparate aminotransferase and plasma ammonia concentrations. Survival following plasmapheresis appeared substantially better than in a non randomized group of similar patients not plasmapheresed. The simplicity of the procedure, biochemical improvements observed and apparent efficacy, suggest that further evaluation of the technique as a means of providing temporary hepatic support is indicated.

Acute Fulminant Hepatic Failure in a Woman Treated With Phenytoin and Trimethoprim-Sulfamethoxazole

2000 ◽  
Vol 124 (12) ◽  
pp. 1800-1803 ◽  
Author(s):  
Marius J-M. Ilario ◽  
Jose E. Ruiz ◽  
Constantine A. Axiotis
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Acute Hepatic Failure ◽  
Hepatic Necrosis ◽  
Rare Occurrence ◽  
Autopsy Findings ◽  
Massive Hepatic Necrosis

Abstract Massive hepatic necrosis following exposure to phenytoin and trimethoprim-sulfamethoxazole is a rare occurrence and to the best of our knowledge has not been reported previously. Acute hepatic failure following administration of trimethoprim-sulfamethoxazole has rarely been seen, and only 4 cases have been well documented pathologically. We report a case of acute liver failure in a 60-year-old woman following ingestion of phenytoin and trimethoprim-sulfamethoxazole concomitantly over a 9-day period. Autopsy findings revealed acute fulminant hepatic failure. This case demonstrates the effects of chemical-chemical interactions in the potentiation of hepatotoxicity of single agents and specifically illustrates the need for discontinuing trimethoprim-sulfamethoxazole in the presence of early liver injury.

scholarly journals Fulminant Hepatic Failure Due to Dengue

2012 ◽  
Vol 9 (2) ◽  
pp. 73-75 ◽  
Author(s):  
A Sedhain ◽  
S Adhikari ◽  
S Regmi ◽  
S K Chaudhari ◽  
M Shah ◽  
...  
Keyword(s):  
Platelet Count ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatic Failure ◽  
Case Reports ◽  
Acute Hepatic Failure ◽  
Reye's Syndrome ◽  
Medical College ◽  
Healthy Female ◽  
Major Outbreak

Dengue Fever (DF) is only rarely considered as a cause of acute liver failure even globally and only a few case reports of acute hepatic failure and encephalopathy occurring in DF in adults are available. We report a case of Acute Liver Failure due to Dengue during a major outbreak in 2010 in Chitwan. A 20 year old previously healthy female presented to the emergency department of Chitwan Medical College with fever, jaundice and altered sensorium. She was tested positive for Dengue IgM. Her biochemical and clinical parameters were suggestive of acute liver failure with total billirubin of 10.1 mg/dL, direct billirubin of 5.2 mg/dL, ALT 5760 IU, AST 14100 IU, alkaline phosphatase of 1250 IU, PT INR of 1.76 and platelet count of 30,000 /mm3. Other causes for acute hepatic failure like acute viral hepatitis, leptospirosis, malaria, Reye’s syndrome were ruled out. The patient was admitted and managed in the ICU with supportive care and platelet transfusion. With treatment she made a significant clinical and biochemical improvement with AST of 105 IU, ALT of 120 IU and platelet count of 150,000/mm3. She was discharged after 11 days of hospital stay.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6293 Kathmandu Univ Med J 2011;9(2):73-5

scholarly journals Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan

JGH Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 428-433
Author(s):  
Takuro Hisanaga ◽  
Isao Hidaka ◽  
Isao Sakaida ◽  
Nobuaki Nakayama ◽  
Akio Ido ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Corticosteroid Therapy ◽  
Hepatic Failure ◽  
Late Onset ◽  
Late Onset Hepatic Failure

scholarly journals The use of hemosorption in liver failure

1981 ◽  
Vol 62 (5) ◽  
pp. 6-9
Author(s):  
V. A. Sitnikov ◽  
V. V. Trusov ◽  
V. A. Lysenko ◽  
A. A. Ivanenkov
Keyword(s):  
Obstructive Jaundice ◽  
Liver Failure ◽  
Hepatic Failure ◽  
Hepatic Coma ◽  
Biliary Cirrhosis ◽  
Serum Hepatitis

The hemosorption method was applied in the treatment of 20 patients (30 hemosorptions). Indications for hemosorption were severe cholemic intoxication and liver failure in obstructive jaundice of gallstone and tumor etiology, hepatic coma in serum hepatitis, cholemic intoxication and liver failure in biliary cirrhosis, eclampsia and renal-hepatic failure. The efficiency and possible complications of hemosorption have been analyzed.

scholarly journals Effect of the Hepatocyte-Specific Deletion of SND1 in Mice on the Liver Insulin Resistance and Acute Liver Failure

2020 ◽  
Author(s):  
Chunyan Zhao ◽  
Xiaoteng Cui ◽  
Baoxin Qian ◽  
Nan Zhang ◽  
Lingbiao Xin ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Cholesterol Level ◽  
Hepatic Steatosis ◽  
Glucose Homeostasis ◽  
Hepatic Failure ◽  
High Fat Diet ◽  
High Fat ◽  
Specific Deletion

Abstract Background: The multifunctional protein SND1 was reported to be involved in a variety of biological processes, such as cell cycle, proliferation or lipogenesis. We previously proposed that global-expressed SND1 in vivo is likely to be a key regulator for ameliorating HFD-induced hepatic steatosis and systemic insulin resistance. Herein, we are very interested in investigating further whether the hepatocyte-specific deletion of SND1 affects the insulin resistance or acute liver failure (ALF) of mice.Methods: By using Cre-loxP technique, we constructed conditional knockout (LKO) mice of SND1 driven by albumin in hepatocytes and analyze the changes of glucose homeostasis, cholesterol level, hepatic steatosis and hepatic failure under the treatment of high-fat diet (HFD) or upon the simulation of Lipopolysaccharide/galactosamine (LPS/GalN).Results: No difference for the body weight, liver weight, and cholesterol level was detected. Furthermore, we did not observe the alteration of glucose homeostasis in SND1 hepatic knockout mice on either chow diet or high-fat diet. Besides, hepatocyte-specific deletion of SND1 failed to influence the hepatic failure of mice induced by LPS/GalN.Conclusions: These findings suggest that hepatic SND1, independently, is insufficient for changing glucose homeostasis, hepatic lipid accumulation and inflammation. The synergistic action of multiple organs may contribute to the role of SND1 in insulin sensitivity or inflammatory response.

Acute Hepatic Failure

2019 ◽  
Author(s):  
Derek J Erstad ◽  
Motaz Qadan
Keyword(s):  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Liver Failure ◽  
Respiratory Distress ◽  
Acute Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Cerebral Edema ◽  
Hepatic Failure ◽  
Distress Syndrome ◽  
Diagnosis And Management

Acute liver failure (ALF) is a rare but highly morbid condition that is optimally managed by a multidisciplinary team of surgeons, hepatologists, and intensivists at a tertiary care center that specializes in liver disorders. ALF is caused by four primary mechanisms, including viral infections (most commonly Hepatitis A and B); toxicity from acetaminophen overdose or other substances; postoperative hepatic failure ; and miscellaneous causes such as autoimmune hepatitis, genetic disorders, or idiopathic etiologies. Unlike chronic liver failure in which the body develops compensatory, protective mechanisms, ALF may be associated with severe multisystem organ involvement, including respiratory distress syndrome, renal failure, and cerebral edema. Fulminant hepatic failure represents a rapidly progressive form of ALF that portends worse prognosis. Prompt diagnosis and management of multisystem organ dysfunction in an intensive care setting is paramount to survival. However, a subset of patients will fail to improve with medical management alone. Early identification of these individuals for emergent transplant listing has been shown to improve outcomes. Multiple predictive models for ALF survival have been developed, which are based on weighted evaluation of clinical and laboratory parameters. These models may be used to facilitate treatment, predict prognosis, and guide transplant listing. In this chapter, we provide an in-depth review these concepts, focusing on the classification, epidemiology, diagnosis, and management of ALF. This review contains 5 tables and 69 references. Key Words: acute liver failure, acute respiratory distress syndrome, coagulopathy, cerebral edema, fulminant hepatic failure, hepatic necrosis, liver transplantation, metabolic disarray, multidisciplinary intensive care, prognostication

scholarly journals Acute Liver Failure with Diffuse Liver Metastasis from Breast Cancer, Not Detected by Computed Tomography: 2 Case Reports

2018 ◽  
Vol 11 (3) ◽  
pp. 699-704 ◽  
Author(s):  
Takatsugu Ogata ◽  
Yuichiro Kikawa ◽  
Misato Ogata ◽  
Hironaga Satake ◽  
Yukimasa Hatachi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Liver Metastasis ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatic Failure ◽  
Poor Prognosis ◽  
Alcoholic Hepatitis ◽  
Case Reports ◽  
History Of

Diffuse liver metastasis is a rare pattern of liver metastasis that is associated with hepatic failure and poor prognosis. We experienced 2 cases of acute liver failure due to diffuse metastasis that could not be detected using computed tomography. In case 1, it was difficult to differentiate diffuse metastasis from alcoholic hepatitis. In case 2, it was difficult to diagnose diffuse liver metastasis because the patient had no history of malignancy. When liver enzyme levels are elevated, it is necessary to consider liver metastasis as a potential cause, regardless of computed tomography findings.

scholarly journals Dengue fever complicated with acute liver failure: A case report of expanded dengue syndrome and literature review

2020 ◽  
Vol 8 ◽  
pp. 2050313X2091342 ◽  
Author(s):  
Navaneethakrishnan Suganthan ◽  
Gajawathana Sakthilingham ◽  
Thirunavukarasu Kumanan
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Dengue Fever ◽  
Dengue Infection ◽  
Dengue Shock Syndrome ◽  
Acute Hepatic Failure ◽  
Fresh Frozen Plasma ◽  
Uneventful Recovery ◽  
Fresh Frozen ◽  
Plasma Leakage

Dengue is the most common arboviral disease, the presentation of which ranges from asymptomatic illness to dengue shock syndrome. Liver is the most common organ affected in dengue, and liver involvement is asymptomatic in majority. Dengue fever is a rare, but a leading cause for acute liver failure in endemic regions. Here, we report a case of a 34-year-old male ethanol user (16 units per week), presented with typical features of dengue infection, which was confirmed serologically, complicated with acute liver failure without clinical, radiological or laboratory evidence of plasma leakage. He was managed with intravenous fresh frozen plasma and N-acetyl cysteine along with other recommended supportive therapies for acute hepatic failure. He made an uneventful recovery.

scholarly journals Venous and arterial ammonia in dairy cows with fatty liver and hepatic failure

2012 ◽  
Vol 49 (No. 6) ◽  
pp. 187-190 ◽  
Author(s):  
P. Mudron ◽  
J. Rehage ◽  
M. Holtershinken ◽  
H. Scholz
Keyword(s):  
Hepatic Encephalopathy ◽  
Liver Failure ◽  
Fatty Liver ◽  
Dairy Cows ◽  
Hepatic Failure ◽  
Clinical Signs ◽  
Plasma Ammonia ◽  
Holstein Friesian ◽  
Triglyceride Content ◽  
Venous Plasma

In the present study we aimed to compare the arterial and venous plasma ammonia in dairy cows with fatty liver and hepatic failure. 75 Holstein-Friesian dairy cows were used in the investigation. Clinical examinations revealed liver failure in 14 cows (group LF). Diagnosis of hepatic failure was based on the clinical signs of hepatic encephalopathy, including anorexia, depressed consciousness, ataxia, somnolence, and coma, and on venous plasma ammonia >35 µmol/l. The other cows were divided according to their liver triglyceride content (wet tissue) into the following groups: low triglycerides (LT) < 30 mg/g (n = 24), medium triglycerides (MT) 30–100 mg/g (n = 31), and high triglycerides (HT) >100 mg/g (n = 6). Both arterial and venous plasma ammonia levels were highest in cows with hepatic failure (93.0 ± 44.9 and 70.4 ± 34.1 µmol/l, respectively). We observed that arterial ammonia was significantly higher than venous ammonia (p < 0.01) only in the dairy cows suffering from liver failure, implying a higher informative value of arterial ammonia in detection of liver function damage in cattle demonstrating signs of hepatic encephalopathy.

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