scholarly journals S2408 Sunitinib-Induced Acute Liver Failure: A Case Presentation

2020 ◽  
Vol 115 (1) ◽  
pp. S1278-S1278 ◽  
Author(s):  
Anum Aqsa ◽  
Sami Droubi ◽  
Shivantha Amarnath ◽  
Hassan Al Moussawi ◽  
Jeffrey R. Abergel
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Case Presentation

scholarly journals Crossroad of infection and autoimmunity in acute liver failure: a case report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Akash Roy ◽  
Sunil Taneja ◽  
Arka De ◽  
Ashim Das ◽  
Ajay K. Duseja ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Autoimmune Hepatitis ◽  
De Novo ◽  
Dramatic Improvement ◽  
Case Presentation ◽  
Wide Range ◽  
Syndromic Diagnosis ◽  
Initial Improvement ◽  
Tropical Infections

Abstract Background Acute liver failure (ALF) is a syndromic diagnosis, consisting of jaundice, coagulopathy, and any degree of encephalopathy in a patient without pre-existing liver disease within 26 weeks of the onset of symptoms. Autoimmune hepatitis has a wide range of presentations and can rarely present as ALF, which frequently tends to be autoantibody negative. Tropical infections like dengue, malaria, and leptospirosis, which present as mimickers of ALF, always remain a differential diagnosis of ALF and mandate an etiology specific management. In rare cases, such infections themselves act as a trigger for autoimmunity. We report a case of diagnostic crossroads of infection and autoimmunity, presenting as acute liver failure and describe the challenges in management. Case presentation A 25-year-old female presented with a syndromic diagnosis of acute liver failure with possibility of tropical illness-related ALF mimic on account of positive Leptospira serology. After initial improvement, there was a rebound worsening of liver functions which prompted a liver biopsy. Biopsy narrowed the differential to Leptospira-associated hepatitis and severe auto-immune hepatitis. Trial of low dose steroid was given which led to dramatic improvement. Conclusion Tropical infections can present as ALF mimics and can themselves act as triggers for autoimmunity. Distinguishing such cases from de-novo acute severe autoimmune hepatitis is difficult and requires therapeutic brinksmanship. An early trial of steroid is mandated but comes with its own challenges.

scholarly journals Infantile fever-triggered acute liver failure caused by novel neuroblastoma amplified sequence mutations: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Weiran Li ◽  
Yu Zhu ◽  
Qin Guo ◽  
Chaomin Wan
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Complete Recovery ◽  
Recurrent Fever ◽  
Compound Heterozygous ◽  
Intravenous Glucose ◽  
Case Presentation ◽  
Genetic Sequencing ◽  
Chinese Girl ◽  
Antipyretic Treatment

Abstract Background Infantile liver failure syndrome-2 (ILFS2) is caused by neuroblastoma amplified sequence (NBAS) mutation. The disease is characterized by recurrent episodes of acute liver failure (ALF) or by liver crisis triggered by recurrent episodes of fever and complete recovery. Case presentation Here, we describe the case of a Chinese girl with typical clinical manifestation of ILFS2 without exhibition of extrahepatic involvement. The patient harbored novel compound heterozygous mutations in the NBAS region (c.3386C > T (p.Ser1129Phe), c.1A > C (p.Met1Leu) and c.875G > A (p.Gly292Glu)), mutations which have not been previously reported. After administration of antipyretics and intravenous glucose and electrolyte administration, the patient recovered fully. Conclusion Through the present study, we recommend that ILFS2 should be taken into consideration during the differential diagnosis of children with recurrent, fever-triggered ALF. While the definitive diagnosis of ILFS2 remains dependent on genetic sequencing and discovery of NBAS, early antipyretic treatment is recommended to prevent liver crisis.

scholarly journals Undiagnosed HIV-related lymphoma associated to EBV co-infection: an autopsy case report

2021 ◽  
Author(s):  
Mariem Grayaa ◽  
Said Saadi ◽  
Ahlem Bellalah ◽  
Sami Ben Jomaa ◽  
Seifeddine Ben Hammouda ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Case Presentation ◽  
Large B Cell Lymphoma ◽  
Hiv Antibodies ◽  
Undiagnosed Hiv ◽  
Epstein Barr ◽  
Macroscopic Examination

Abstract Background: The diffuse large-B-cell lymphoma (DLBCL) is known as one of the most neoplasm that occurs in AIDS patients. In rare cases, this tumor is manifested with acute liver failure. Case presentation: We report a case of patient who was presented with jaundice and hepatomegaly due to an acute liver failure. A blood exposure accident helped the operator to discover the seropositive statue of the deceased. The results confirmed the presence of HIV antibodies in patient’s serum. Macroscopic examination of the spleen showed a well-defined subcapsular nodule. It had a micronodular appearance. Immunohistochemistry was also performed. Conclusion: The diagnosis of DLBCL related to HIV associated to an Epstein-Barr infection was established in postmortem.

scholarly journals Acute liver failure caused by Amanita verna: a case series and review of the literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianlong Wu ◽  
Xueyi Gong ◽  
Zemin Hu ◽  
Qiang Sun
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Toxic Hepatitis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Toxic Encephalopathy ◽  
Mushroom Poisoning ◽  
Wild Mushrooms ◽  
Case Presentation

Abstract Background Amanita verna is one of the most harmful wild fungi in China. Amanita verna poisoning occurs every year, and the mortality is as high as 50%. However, its clinical manifestations are complex and diverse. Case presentation In March 2019, three patients took a large amount of Amanita, and one of them received liver transplantation in Zhongshan hospital, Sun Yat-sen University. All patients had vomiting and diarrhea 8–12 h after eating wild mushrooms (Amanita). The patients were initially diagnosed with Amanita poisoning. One case (case 3) was complicated and diagnosed as mushroom poisoning (fatal Amanita), toxic hepatitis, acute liver failure, toxic encephalopathy, hemorrhagic colitis, toxic myocarditis, disseminated intravascular coagulation (DIC) and pregnancy. The general clinical data of all patients were recorded, who received early treatment such as hemodialysis, artificial liver plasma exchange, hormone shock and anti-infection. One case (case 1) recovered smoothly after liver transplantation, and the indexes of liver, kidney, coagulation function and infection were improved. The other two cases died of intracerebral hemorrhage. Conclusion Liver transplantation is an effective method for the treatment of acute liver failure caused by mushroom poisoning and can improve the survival rate of patients with toxic liver failure.

scholarly journals Case Report: Levetiracetam causing acute liver failure complicating post-operative management in a neurosurgical patient

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 187 ◽  
Author(s):  
Sharanya Jayashankar ◽  
Sunil Munakomi ◽  
Vignesh Sayeerajan ◽  
Prakash Kafle ◽  
Pramod Chaudhary ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
External Ventricular Drain ◽  
Operative Management ◽  
Sudden Onset ◽  
Dramatic Improvement ◽  
Case Presentation ◽  
Neurosurgical Patient ◽  
Life Threatening ◽  
Excellent Safety Profile

Background: Herein we report a rare case of acute liver failure due to levetiracetam, which has been considered to have an excellent safety profile with minimal hepatic side effects. Case presentation: A 55-year-old male patient presenting with sudden onset dizziness, slurring of speech and headache was operated for posterior fossa cerebellar hematoma. His post-surgical period was complicated by development of icterus with elevation of liver enzymes. After ruling out common inciting factors, it was decided to stop levetiracetam which was given prophylactically for preventing seizures owing to presence of external ventricular drain. From the next day patient had dramatic improvement in liver functions and sensorium. Conclusions: We would like to highlight this side effect that is potentially life threatening, though rare, of levetiracetam, which is very commonly used in today’s practice and fast superseding all other time-tested antiepileptics.

scholarly journals Pediatric Acute Liver Failure in Sickle Cell Disease

2021 ◽  
pp. 1-5
Author(s):  
Luís Rodrigues ◽  
Sofia Almeida ◽  
Catarina Salgado ◽  
Cristina Gonçalves
Keyword(s):  
Sickle Cell Disease ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Sickle Cell ◽  
Exchange Transfusion ◽  
Cell Disease ◽  
Case Presentation ◽  
History Of ◽  
Fatal Liver Failure ◽  
Pediatric Acute Liver Failure

<b><i>Introduction:</i></b> Sickle cell intrahepatic cholestasis (SCIC) is one of the rarest and the most severe acute hepatic manifestations of sickle cell disease (SCD) and it can rapidly progress to acute liver failure. It is associated with a high mortality rate, demanding prompt recognition and management. <b><i>Case Presentation:</i></b> We report a case of a 7-year-old boy with a history of homozygous HbS SCD who presented to the emergency department with fever, increasing abdominal pain, and jaundice. His course was complicated by acute liver injury (AST 9,472 IU/L, ALT 2,683 IU/L, total bilirubin 15.4 mg/dL; conjugated bilirubin 8.69 mg/dL, hypoalbuminemia 2.6 g/dL, and persistent hypoglycemia), with acute liver failure (coagulopathy not corrected by vitamin K administration with INR 3.26, decreased factors V 10% and VII 28%, and West Haven grade I hepatic encephalopathy associated with mild hyperammonemia of 71 µmol/L). After excluding other causes of acute liver failure, the patient was diagnosed as having SCIC and was successfully treated with manual exchange transfusion. <b><i>Conclusion:</i></b> This case reinforces that exchange transfusion is an effective treatment for SCIC and that it should be introduced promptly to prevent fulminant and potentially fatal liver failure.

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