What should be included in the evaluation of acute liver failure (ALF)?

Updated: Jun 13, 2019
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
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The most important step in patients with acute liver failure is to identify the cause. [38, 39] Prognosis in acute liver failure is dependent on the etiology. Acute liver failure from certain causes demands immediate and specific treatment. It is also critical to identify those patients who will be candidates for liver transplantation. [38, 39]

All patients with clinical or laboratory evidence of moderate or severe acute hepatitis should have immediate measurement of prothrombin time (PT) and careful evaluation of the mental status. Prolongation of the PT, an international normalized ratio (INR) above 1.5, or alteration in mental sensorium is grounds for hospital admission or transfer to a specialized unit. [39]

A complete blood cell (CBC) count in patients with liver failure may reveal thrombocytopenia.

Consider electroencephalography in the evaluation of a patient with encephalopathy if seizures must be excluded.

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