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A different form of acute liver failure

Gastroenterology & Hepatology: Open Access
Sara Joana Faria, Joana Dias Antunes, Patrícia Amaral, Luísa Loureiro, Isabel Bessa, Amélia Pereira

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Acute liver failure (ALF) is a syndrome characterized by a sudden insult with liver dysfunction and necrosis. It has several etiologies, and it is characterized by an abrupt increase in transaminases, encephalopathy and coagulopathy. The authors intent to expose a rare case of occult neoplasm that caused ALF as the first manifestation and alert the clinicians about the warning signs of ALF as well as the diagnostic approach to be adopted. We present the case of a 71-year-old man that was admitted to hospital due to heart failure and hepatic cytocolestasis, with evolution into hyperacute liver failure on the 7th day of hospitalization, and a final diagnosis of grade 3 small cell neuroendocrine carcinoma. 


ALF, acute liver failure, INR, international normalized ratio, ON, occult neoplasm, CT, computed tomography, NEN, neuroendocrine neoplasms, liver biopsy, neuroendocrine carcinoma, occult neoplasm