Pathophysiology of Acute Liver Failure. Nutr Clin Pract 2020 Feb;35(1):24-29
Date
12/17/2019Pubmed ID
31840297DOI
10.1002/ncp.10459Scopus ID
2-s2.0-85076916243 (requires institutional sign-in at Scopus site) 77 CitationsAbstract
Acute liver failure (ALF) is a rare syndrome resulting from an acute insult to the liver in patients without known underlying chronic liver disease. It is characterized by loss of synthetic function in the form of jaundice and coagulopathy and development of hepatic encephalopathy. Multiorgan failure (MOF) eventually develops, leading to death. Many different etiologies have been identified, with acetaminophen (APAP) overdose and viral hepatitis being the most common causes worldwide. The pathophysiology of ALF can be divided into cause-specific liver injury pathophysiologies and pathophysiology related to occurrence of secondary MOF. In terms of liver injury pathophysiology, APAP toxicity is the most well known. Secondary MOF is often a result of the initial massive proinflammatory response generating a systemic inflammatory response syndrome followed by a compensatory anti-inflammatory response leading to immune cell dysfunction and sepsis. As the liver is a tremendously important metabolic organ involved in energy metabolism, protein synthesis, fat metabolism, and glycemic control, multiple aspects of nutrition also need to be considered as part of the overall pathophysiology of ALF.
Author List
Dong V, Nanchal R, Karvellas CJAuthor
Rahul Sudhir Nanchal MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AcetaminophenAnalgesics, Non-Narcotic
Chemical and Drug Induced Liver Injury
Drug Overdose
Female
Hepatic Encephalopathy
Hepatitis, Viral, Human
Humans
Liver Failure, Acute
Male
Multiple Organ Failure
Nutritional Status
Sepsis
