Case of the Month #53 AFLP

Published 04/12/2024

Other Non-Obstetric Causes of Liver Failure

In managing postpartum liver failure, it is essential to consider non-obstetric causes, which can often mimic or worsen obstetric conditions like HELLP syndrome or AFLP. Key non-obstetric causes include:

  • Viral Hepatitis: Acute liver failure can result from viral infections such as hepatitis B, hepatitis C, and herpes simplex virus. These infections can present with jaundice, coagulopathy, and encephalopathy, necessitating prompt diagnosis and antiviral treatment.
  • Drug-Induced Liver Injury: Certain medications, including paracetamol (acetaminophen) and some antibiotics can cause acute liver injury. It is important to review the patient's medication history to identify potential hepatotoxic drugs that could contribute to liver dysfunction.
  • Autoimmune Hepatitis: Though less common, autoimmune hepatitis can present acutely and lead to rapid hepatic decompensation.
  • Sepsis-Related Cholestasis: Sepsis, particularly with Gram-negative organisms, can lead to cholestasis and subsequent liver dysfunction. This highlights the need for thorough investigation and appropriate management of underlying infections to prevent further hepatic deterioration.