7/26 Morning Report w/ JLo: Fluctuating Liver Failure of Unclear Etiology

An elderly woman w/ history of recurrent idiopathic colitis and ESRD 2/2 FSGS presents with leukocytosis and liver failure. Liver abnormalities were presumed 2/2 sepsis cholestasis and managed conservatively; she initially improved but then had a rapid decline of hypoglycemia, lactic acidosis, and PEA arrest with worsened LFTs of unclear etiology. Still evolving in the ICU – we don’t have a diagnosis yet but will keep you updated!
*Define Acute Liver Failure: “new liver test abnormalities with impaired synthetic function (INR > 1.5) + encephalopathy developing in
 
Acute liver injury is a somewhat informal term used when criteria for ALF aren’t met – often if very elevated transaminases without elevated INR or encephalopathy*
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