Based on the aetiology of ALF, the timing and indications of the clinical features of ALF may vary. The major indications of ALF range from simple symptoms to severe ones. These include
- Abdominal pain
- Hepatic encephalopathy (drowsiness, confusion, cognitive impairment, slowed mentation, and euphoria to deep coma)
With these symptoms, patients may also develop coagulation abnormalities (Prolonged PT/INR). This increases the risk of bleeding. However, due to further testing the chances to diagnose ALF may be delayed or even missed and the opportunity to provide definitive therapy is also lost. Therefore to make an early diagnosis of ALF, it is important to have a high index of suspicion.
The course of treatment for ALF is similar to that of multiple organ failure. The pathophysiology for ALF include
- Loss of hepatocyte function
- The release of toxins and cytokines
This is due to liver necrosis causing severe systemic inflammation and secondary bacterial infections from decreased immunity in ALF.