Rapid development of liver failure or dysfunction [hepatocellular dysfunction]

Encephalopathy can be seen

Usually occurs when a history of liver disease is present

However, in some cases there is an absence of a prior history of liver disease

The liver is a central mode of control for many enzymes and detoxification of the blood

Several causes include

   -  Drugs
   -  Alcohol
   -  Viruses
   -  Toxins
   -  Reye Syndrome
   -  Wilsons Disease
   -  and others

 
Drug examples include:
   -  Acetaminophen - most common drug
   -  Halothane
   -  Isoniazid
   -  Valproate
   -  Sulfonamides
   -  Phenytoin
   -  Thiazolidinedione
   -  Some herbal remedies
   -  and others

Classification [from 1993]:

Hyperacute as within 1 week
Acute as 8-28 days
Subacute as 4-12 weeks

Symptoms:

   -  Jaundice
   -  Severe damage to liver cells
   -  Decrease coagulation
   -  Thormbocytopenia
   -  Increase platelet function
   -  Renal failure is seen in 40-50% of the time
   -  Encephalopathy

Individuals can present as hepatocellular injury, hepatic encephalopathy, infection, GI bleed, or multiple organ failure

Treatment:

   -  Hospital Admission is often necessary
 
   -  Nutrition improvement

   -  Liver transplant