Abstract
ABSTRACTBackgroundAcute liver failure (ALF) is a critical illness with a large number of viral and nonviral causes. Clinical course and etiologies in the Asian countries are different from those reported from the Western world and mortality is high. There may even be intracountry variations in large countries like India, which have differing culture, ethnicity, and environment. Data from North-east part of India is lacking.Materials and methodsAcute liver failure cases (>14 years of age) seen over a period of 8 years (n = 255) were studied at a Government Medical College in Assam for their etiological and other demographic profile. Viral serology was carried out and revalidated at a laboratory in New Delhi.ResultsMajority of cases were <30 years of age. Commonest etiology was nonviral (non-ABCE). Amongst viral causes, hepatitis A and E were common, while hepatitis B virus (HBV) was rare. Unknown herbal medication use was very frequent in our cases with a significantly higher mortality. Mortality was highest in cases in 3rd decade of life. Statistically, international normalized ratio (INR) was the strongest predictor of death.ConclusionUnlike the rest of India, hepatitis virus is not the major cause of ALF in our part; hepatitis A being commoner than hepatitis E, and B is rare. Unknown herbal medications are major cause of mortality and is important medicosocial issue. Our study highlights the differences in the profile of ALF from other Indian and western studies, possibly due to sociocultural factors prevalent in this part.How to cite this articleDas AK, Begum T, Kar P, Dutta A. Profile of Acute Liver Failure from North-east India and Its Differences from other Parts of the Country. Euroasian J Hepato-Gastroenterol 2016;6(2):111-115.
Highlights
Acute liver failure (ALF) is a life-threatening emergency, but potentially reversible condition, of varied etiology
As per reports from India, about one-third of ALF patients survive with aggressive conservative therapy, whereas two-thirds of all deaths occur within 72 hours of hospitalization.[10]
As our patients presented within a week of onset of encephalopathy, we considered the unknown herbs to be associated with ALF in our series in those who gave a positive history of such ingestion prior to hospitalization
Summary
Acute liver failure (ALF) is a life-threatening emergency, but potentially reversible condition, of varied etiology. Treatment is directed at early recognition of the cause, complications, and general supportive measures, but despite advanced intensive care, mortality may be as high as 40 to 80%, which is mostly related to its complications like cerebral edema and sepsis.[1] Orthotropic liver transplantation (OLT) has become an established treatment option in patients with ALF and is becoming increasingly available in developing nations including India. Acute liver failure (ALF) is a critical illness with a large number of viral and nonviral causes. Clinical course and etiologies in the Asian countries are different from those reported from the Western world and mortality is high.
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