Acute liver failure classification: Difference between revisions

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==Overview==
==Overview==
Acute liver failure is classified into three subcategories; hyperacute , acute, and subacute depending upon the time lapsed between the appearance of [[jaundice]], to the development of [[encephalopathy]]. In can also be classified into [[fulminant]] and subfulminant based upon the time that has lapsed from the start if illness to the onset of encephalopathy.


==Classification==
==Classification==

Revision as of 22:01, 26 October 2017

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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] Aditya Govindavarjhulla, M.B.B.S. [3]


Overview

Classification

Acute liver failure may be classified on the basis of the duration of the symptoms between the onset of jaundice to the onset of encephalopathy. The different classification systems based on the number of weeks from the appearance of jaundice to the encephalopathy are:[1] [2][3][4][5][6]

Classification system Duration
O’Grady System
  • Hyperacute (0 - 1 week)
  • Acute ( From 2nd week - 4 weeks)
  • Subacute ( From 4th week - 12 weeks)
Bernuau System
  • Fulminant ( 0 - 2 weeks)
  • Subfulminant ( 2 weeks - 12 weeks)
Japanese System
  • Fulminant (0 - 8 weeks)
    • Acute ( 0 - 1.5 weeks)
    • Subacute ( 1.5 weeks - 8 weeks)
  • Late-Onset ( 8 weeks - 12 weeks)
  • This classification based on time duration provides helpful clues about etiology, complications, and prognosis such as in hyperacute cases the cause is usually viral infections or acetaminophen toxicity.
  • The subacute cases can be due to idiosyncratic drug reactions and can also be confused with chronic liver disease.
  • The hyperacute liver failure has a better prognosis than subacute liver failure.

Classification based on etiology

References

  1. O'Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet 1993;342:273-5. PMID 8101303.
  2. O'Grady JG (2005). "Acute liver failure". Postgraduate medical journal. 81 (953): 148–54. doi:10.1136/pgmj.2004.026005. PMID 15749789.
  3. Williams R (1996). "Classification, etiology, and considerations of outcome in acute liver failure". Seminars in Liver Disease. 16 (4): 343–8. doi:10.1055/s-2007-1007247. PMID 9027947. Retrieved 2012-10-26. Unknown parameter |month= ignored (help)
  4. O'Grady, JG.; Schalm, SW.; Williams, R. (1993). "Acute liver failure: redefining the syndromes". Lancet. 342 (8866): 273–5. PMID 8101303. Unknown parameter |month= ignored (help)
  5. 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. Unknown parameter |month= ignored (help)
  6. Mochida, S.; Nakayama, N.; Matsui, A.; Nagoshi, S.; Fujiwara, K. (2008). "Re-evaluation of the Guideline published by the Acute Liver Failure Study Group of Japan in 1996 to determine the indications of liver transplantation in patients with fulminant hepatitis". Hepatol Res. 38 (10): 970–9. doi:10.1111/j.1872-034X.2008.00368.x. PMID 18462374. Unknown parameter |month= ignored (help)

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