20th April 2024

Diagnosis

Acute liver failure is a clinical diagnosis based on the presence of hepatic encephalopathy in a patient with acute liver disease. Blood tests will show significantly elevated transaminases (ALT and AST) and bilirubin, prolonged prothrombin time (PT) and high INR (>1.5), and usually low platelet count and serum albumin. Hypoglycaemia is common and patients may develop metabolic acidosis. Paracetamol levels should be performed in patients with suspected overdose, as they can guide treatment. Signs of chronic liver disease (portal hypertension) are absent in acute liver failure.