How is fulminant hepatic failure (FHF) differentiated from liver failure?

Updated: Jun 13, 2019
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
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Answer

Some patients with previously unrecognized chronic liver disease decompensate and present with liver failure; although this is not technically FHF, discriminating such at the time of presentation may not be possible. Patients with Wilson disease, vertically acquired hepatitis B, or autoimmune hepatitis may be included in spite of the possibility of cirrhosis, if their disease has been manifest for less than 26 weeks.

The most important step in the assessment of patients with acute liver failure is to identify the cause, as certain causes demand immediate and specific treatment (see Workup). Drug-related hepatotoxicity, especially from acetaminophen, is the leading cause of acute liver failure in the United States (see Etiology).


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