LIVER FAILURE

acute:

fulminant viral hepatitis (A, rarely B, C, E or G)

acute alcoholic hepatitis

mushroom poisoning (Amanita phalloides)

ischaemic hepatopathy, e.g. associated with hypovolaemic shock

acute fatty liver of pregnancy (rare)

Reye's syndrome (associated with aspirin use in children; rare)

leptospirosis

acute hepatitis in Wilson's disease (rare)

drug-induced liver necrosis:

halothane

paracetamol overdose

MAOIs

anti-tuberculous drugs

carbon tetrachloride [AST typically >25,000]

other

chronic:

conditions usually leading to liver cirrhosis:

alcoholic liver disease

haemochromatosis

primary biliary cirrhosis

chronic hepatitis B infection

chronic hepatitis C infection

autoimmune ('lupoid') hepatitis

primary sclerosing cholangitis

Wilson's disease

a1-antitrypsin deficiency

non-alcoholic steato-hepatitis (NASH)

drugs:

a-methyldopa

isoniazid

nitrofurantoin

oxyphenacetin

miscellaneous causes: cryptogenic cirrhosis

acute on chronic (conditions causing decompensation):

infection (including spontaneous bacterial peritonitis)

shunt surgery

alcohol

delta virus infection in hepatitis B

protein meal

upper GI bleed

development of hepatoma

drugs or toxins, e.g. alcohol

any other 'insult' to the liver

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