ALF - Other Causes*****

Question 1

Non-paracetamol drug induced ALF is a diagnosis of exclusion.

What hep virus is commonly misdiagnosed as a drug induced liver failure?

What drug used to treat TB? - R

What antibiotic used to Rx UTI’s could be cause?

What anti-epileptic drugs could be a cause?

Why are NSAID’s avoided?

Answer 1

Hep E

Rifampicin

Nitrofurantoin

Due to the increased hepatorenal syndrome

Valproate

Question 2

Ischaemic injury:

What 2 recreational drugs can cause this?

Answer 2

Cocaine

MDMA

Question 3

Viral hepatitis:

What 3 hep viruses are you concerned about?

Autoimmune hepatitis - what is needed for diagnosis?

Answer 3

Hep A, B and E

Autoantibodies and immunoglobulin testing

Question 4

What is it called if you can’t find a reason for the ALF?

Answer 4

Indeterminante ALF

Question 5

List some pregnancy related liver disease?

Answer 5

HG
Pre-eclampsia and eclampsia (due to hepatic rupture)
HELLP syndrome
Acute fatty liver of pregnancy

Question 6

Miscellaneous cause of ALF:

Malignant infiltration of the liver can present as ALF.

What toxins can cause ALF? - 4

Budd-Chiari syndrome - what is it?

Wilson’s disease can also cause it. What is it?

Answer 6

Cocaine
Ecstasy - MDMA
Herbal remedies
Mushrooms

ALF with previous hepatic vein thrombosis

Inability for the liver to metabolise copper properly so there is a build up copper