Acute Hepatic Failure

What is Acute Hepatic Failure? Also referred to as acute liver failure, acute hepatic failure is a sudden, severe injury to the hepatocytes accompanied by symptoms of encephalopathy and impairment of synthetic function in a patient who does not have chronic liver disease or cirrhosis. Acute hepatic failure is rare, affecting around 1 out of 1 million people annually in the United States.

What causes Acute Hepatic Failure?


Acute hepatic failure has several etiological factors:

  • Acetaminophen toxicity
  • Ischemia
  • Drug-induced injury
  • Viral infections, such as Hepatitis A, B, and E, HSV, and EBV
  • Autoimmune hepatitis
  • Heat Stroke
  • Pregnancy-associated injuries, such as acute fatty liver of pregnancy and HELLP syndrome.
  • Budd Chiari syndrome.


Symptoms of Acute Hepatic Failure


The initial symptoms of acute hepatic failure can be nonspecific and may include:

  • Fatigue
  • Lethargy
  • Nausea/Vomiting
  • Abdominal pain in the upper right quadrant
  • Anorexia 
  • Pruritus


Symptoms then progress rapidly to the development of jaundice, ascites, and confusion. Without treatment, it can lead to multi-organ dysfunction, coma, and death.

Source: Stravitz, R. T., & Lee, W. M. (2019). Acute liver failure. The Lancet, 394(10201), 869–881.