Fulminant Hepatic Failure
نویسنده
چکیده
Acute liver failure (ALF), also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. This condition is uncommon but not rare; it affects approximately 2000 to 2800 people annually in the United States, with a mortality of 3.5 per million despite intensive support. Loss of hepatocyte function sets in motion a vicious multiorgan dysfunction syndrome, with ensuing death even when the liver has begun to recover. Complications of FHF include encephalopathy, cerebral edema, sepsis, acute respiratory distress syndrome (ARDS), hypoglycemia, coagulopathy, gastrointestinal bleeding, pancreatitis, and acute renal failure (ARF). Acetaminophen toxicity, idiosyncratic drug reactions, and hepatotropic viruses remain the most common cause of FHF in the United States. FHF accounts for 5% to 6% of liver transplantation, which is currently the only proven and definitive treatment option for patients who are unlikely to recover spontaneously. Unfortunately, many patients die before a suitable organ can be identified. Thus, the dominant medical interventions for acute liver failure in the critical care setting are supportive. Alternative “liver replacement” therapeutic strategies are under clinical investigation.
منابع مشابه
Acute fulminant hepatic failure due to colchicine – a rare manifestation of Gloriosa superba poisoning.
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