Last reviewed 01/2018

The aetiology of acute liver failure is subject to great geographical variation, dependent on endemic infection and social behaviour - the predilection for paracetamol as a method of parasuicide in the UK is reflected in the emergence of this drug as the greatest aetiological factor.

Other causes include:

  • viral hepatitis:
    • hepatitis B casues up to 70% if cases
    • superinfection with delta agent

  • drug reactions:
    • up to 10% of cases
    • halothane
    • isoniazid
    • methyldopa
    • phenytoin

Rarer causes include:

  • vascular causes
  • hyperthermia
  • hepatic vein obstruction, the Budd-Chiari syndrome
  • massive malignant infiltration
  • Wilson's disease
  • Leptospirosis / Weil's disease
  • autoimmune disease
  • carbon tetrachloride
  • Amanita phalloides (the death cap mushroom)
  • Reye's syndrome