Acute Liver Failure Symptoms & Causes

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Contact the Center for Childhood Liver Disease

What causes liver failure?

A number of liver diseases, such as biliary atresia, metabolic liver disease and hepatitis, can lead to liver failure as they progress into late stages.

Liver diseases that can lead to liver failure share the following characteristics:

  • Jaundice - A yellow discoloration of the skin and whites of your child’s eyes due to an abnormally high level of bilirubin (bile pigment) in his bloodstream.
    • High levels of bilirubin may be attributed to inflammation or other abnormalities of the liver cells or blockage of the bile ducts.

    • Sometimes jaundice is caused by the breakdown of a large number of red blood cells, which can occur in newborns.

    • Jaundice is usually the first sign, and sometimes the only sign, of liver disease.

  • Cholestasis - Reduced or stopped bile flow.

    • Bile flow may be blocked inside your child’s liver, outside the liver or in both places.

    • Cholestasis can be caused by hepatitis, metabolic liver diseases, drug effects, a stone in the bile duct, bile duct narrowing, biliary atresia or inflammation of the pancreas.

    • Symptoms of cholestasis may include the following:

      • dark urine
      • jaundice
      • pale stool
      • easy bleeding
      • itching
      • small, spider-like vessels visible in the skin
      • enlarged spleen
      • fluid in the abdominal cavity
      • chills
      • abdominal pain
  • Liver enlargement (hepatomegaly) is usually an indicator of liver disease.
    • There are usually no symptoms associated with a slightly enlarged liver.
    • Symptoms of a grossly enlarged liver include abdominal discomfort or "feeling full."
  • Portal hypertension — Abnormally high blood pressure in your child’s portal vein, which brings blood from the intestine to the liver.
    • Portal hypertension may be due to increased blood pressure in the portal blood vessels or resistance to blood flow through the liver.

    • Portal hypertension can lead to the growth of new blood vessels that bypass the liver.

    • When this occurs, substances that are normally removed by the liver pass into the general circulation.

    • Symptoms of portal hypertension may include:

      • a distended abdominal cavity (ascites)

      • prominence of abdominal wall veins

      • bleeding of the varicose veins at the lower end of the esophagus or the stomach lining

  • Ascites — Fluid build-up in your child’s abdominal cavity caused by fluid leaks from the vessels on the surface of the liver and intestine.
    • Ascites due to liver disease usually accompanies other liver disease characteristics such as portal hypertension.

    • Symptoms of ascites may include a distended abdomen, which causes discomfort and shortness of breath.

  • Liver encephalopathy — The deterioration of your child’s brain function due to toxic substances building up in the blood which are normally removed by the liver.

    • Liver encephalopathy is also called portal-systemic encephalopathy, hepatic encephalopathy, or hepatic coma.

    • Symptoms of liver encephalopathy may include:

      • changes in logical thinking, personality and behavior
      • mood changes
      • impaired judgment
      • drowsiness
      • confusion
      • sluggish speech and movement
      • disorientation
      • loss of consciousness and coma

What are the symptoms of liver failure?

  • jaundice
  • tendency to bruise or bleed easily
  • ascites
  • impaired brain function (encephalopathy)
  • poor weight gain and growth
  • fatigue
  • weakness
  • nausea
  • loss of appetite
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