Diseases & Conditions

Acute liver failure

Acute liver failure occurs when your liver rapidly loses its ability to function. More commonly, liver failure develops slowly over the course of years. But in acute liver failure, liver failure develops in a matter of days.

Acute liver failure can cause many complications, including excessive bleeding and increasing pressure in the brain. Another term for acute liver failure is fulminant hepatic failure.

Acute liver failure is a medical emergency that requires hospitalization. Some causes of acute liver failure can be reversed with treatment. But in other situations, a liver transplant may be the only cure for acute liver failure.

Signs and symptoms of acute liver failure may include:

• A yellowing of your skin and eyeballs (jaundice)
• Tenderness in the upper right area of your abdomen
• Nausea
• Vomiting
• A general sense of not feeling well
• Difficulty concentrating
• Disorientation or confusion
• Sleepiness
• Muscle tremors

When to see a doctor
Acute liver failure can develop quickly in an otherwise healthy person, and it is life-threatening. If you or someone you know suddenly develops a yellowing of the eyes or skin, tenderness in the upper abdomen or any unusual changes in mental state, personality or behavior, seek medical attention right away.

Acute liver failure occurs when liver cells are damaged significantly and no longer able to function. Acute liver failure has many potential causes, including:

• Acetaminophen overdose. Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the United States. Acute liver failure can occur if you take a very large dose of acetaminophen all at once, or it can occur if you take smaller doses every day for several days, especially in people with chronic liver disease.
• Prescription medications. Some prescription medications can cause acute liver failure, including antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants, among others.
• Herbal supplements. Herbal drugs and supplements have been linked to acute liver failure, including kava, ephedra, skullcap and pennyroyal, among others.
• Hepatitis and other viruses. Hepatitis A, hepatitis B and hepatitis E can cause acute liver failure. Other viruses that can cause acute liver failure include Epstein-Barr virus, cytomegalovirus and herpes simplex virus.
• Toxins. Toxins that can cause acute liver failure include the poisonous wild mushroom Amanita phalloides, which is sometimes mistaken for other edible species.
• Autoimmune disease. Liver failure can be caused by autoimmune hepatitis — a disease in which your immune system attacks liver cells, causing inflammation and injury.
• Diseases of the veins in the liver. Vascular diseases that cause blockages to form in the veins of the liver can cause acute liver failure. These include portal vein thrombosis, Budd-Chiari syndrome and venoocclusive disease.
• Metabolic disease. Rare metabolic diseases, such as Wilson's disease, acute fatty liver of pregnancy and Reye's syndrome, infrequently cause acute liver failure.
• Cancer. Cancer that begins in your liver or cancer that spreads to your liver from other places in your body can cause your liver to fail.

Many cases of acute liver failure have no apparent cause.