Drug-Induced Acute Liver Failure

Clin Liver Dis. 2017 Feb;21(1):151-162. doi: 10.1016/j.cld.2016.08.003. Epub 2016 Oct 2.

Abstract

Drug-induced acute liver failure (ALF) disproportionately affects women and nonwhites. It is most frequently caused by antimicrobials and to a lesser extent by complementary and alternative medications, antiepileptics, antimetabolites, nonsteroidals, and statins. Most drug-induced liver injury ALF patients have hepatocellular injury pattern. Cerebral edema and intracranial hypertension are the most serious complications of ALF. Other complications include coagulopathy, sepsis, metabolic derangements, and renal, circulatory, and respiratory dysfunction. Although advances in intensive care have improved outcome, ALF has significant mortality without liver transplantation. Liver-assist devices may provide a bridge to transplant or to spontaneous recovery.

Keywords: Cerebral edema; Drug hepatotoxicity; Encephalopathy; Liver failure; Liver transplantation.

Publication types

  • Review

MeSH terms

  • Brain Edema / chemically induced*
  • Brain Edema / mortality
  • Brain Edema / physiopathology
  • Critical Care / methods
  • Critical Illness / mortality
  • Disease Progression
  • Female
  • Hepatic Encephalopathy / chemically induced*
  • Hepatic Encephalopathy / mortality
  • Hepatic Encephalopathy / physiopathology
  • Hospital Mortality / trends
  • Humans
  • Liver Failure, Acute / chemically induced*
  • Liver Failure, Acute / mortality
  • Liver Failure, Acute / physiopathology
  • Male
  • Risk Assessment
  • Survival Analysis
  • United States