Acute liver failure history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Obtaining the focused history is an important aspect of making a diagnosis of an acute liver failure. It provides insight into the cause, precipitating factors, prognosis and the correct therapy. Specific areas of focus when obtaining a history from the patient include timing of the onset of jaundice, alcohol intake, medications, family history, risk factors of viral hepatitis and past medical history. Common symptoms of acute liver failure include anorexia, malaise, pruritus, bleeding tendencies, confusion, disorientation, and stupor.

History and Symptoms

History

Obtaining the focused history is an important aspect of making a diagnosis of an acute liver failure. It provides insight into the cause, precipitating factors and associated comorbid conditions. The complete history will help determine the correct therapy and helps in determining the prognosis. The hepatic encephalopathic patients are disoriented therefore the patient interview may be difficult. In such cases, history from the family members may need to be obtained. The specific history of the symptoms (duration, onset, progression), associated symptoms, drug usage has to be obtained. Specific areas of focus when obtaining the history are:[1][2][3]

Symptoms

The initial symptoms of acute liver failure can be nonspecific such as nausea, fatigue, and malaise. The patients may have jaundice on initial presentation. The patients with initial subtle mental changes can also rapidly deteriorate to a comatose state.

References

  1. O'Grady JG, Schalm SW, Williams R (1993). "Acute liver failure: redefining the syndromes". Lancet. 342 (8866): 273–5. PMID 8101303.
  2. Acharya SK, Panda SK, Saxena A, Gupta SD (2000). "Acute hepatic failure in India: a perspective from the East". J. Gastroenterol. Hepatol. 15 (5): 473–9. PMID 10847431.
  3. Bernuau J, Rueff B, Benhamou JP (1986). "Fulminant and subfulminant liver failure: definitions and causes". Semin Liver Dis. 6 (2): 97–106. doi:10.1055/s-2008-1040593. PMID 3529410.



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