What are the common causes of acute liver failure (ALF)?

Updated: Jun 13, 2019
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
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Numerous causes of fulminant hepatic failure exist, but hepatotoxicity due to acetaminophen and idiosyncratic drug reactions is the most common cause in the United States. For nearly 15% of patients, the cause remains indeterminate.

Viral hepatitis may lead to hepatic failure. Hepatitis A and B account for most of these cases. In the developing world, acute hepatitis B virus (HBV) infection dominates as a cause of fulminant hepatic failure because of the high prevalence of the disease.

Hepatitis C rarely causes acute liver failure. Hepatitis D, as a coinfection or superinfection with hepatitis B virus, can lead to fulminant hepatic failure. Hepatitis E (often observed in pregnant women) in endemic areas is an important cause of fulminant hepatic failure.

Atypical causes of viral hepatitis and fulminant hepatic failure include the following:

Autoimmune hepatitis may also result in hepatic failure.

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