What would make the liver quit working?

A cirrhotic liver. (iStockphoto/Thinkstock)
A cirrhotic liver. (iStockphoto/Thinkstock)

Dear Dr. B: What would make the liver quit working? This person did not use alcohol. Could West Nile virus, hepatitis or E. coli possibly affect your liver?

Two most common causes of liver failure in North America are alcohol and acetaminophen use. Acetaminophen is present in over-the-counter pain and cold medications like Tylenol. We will come to this later. Let me first answer your question.

As far as I know, West Nile virus does not cause liver failure. Usually. West Nile fever resolves spontaneously and completely. In a worst case scenario, fatigue, headache, weakness, movement disorders can persist for weeks or months. Severe disease involving the nervous system can result in death or permanent disability. Death is from swelling of the brain and respiratory failure.

Hepatitis does cause liver failure. Hepatitis is a generic term used for inflammation and damage to the liver cells. The liver cells can be damaged by drugs, any kind of toxins, alcohol, inherited diseases, certain metabolic diseases and viruses. Generally speaking, when we say hepatitis, it refers to viral hepatitis A, B, and C. Hepatitis C is the commonest reason for liver transplant in the U.S.

E. coli infection is very common. But it is not a common cause of liver failure. E. coli can cause infection of the urinary tract, gallbladder, bile ducts and the infection, in rare cases, travel to the the liver, brain (meningitis) or lungs (pneumonia). The majority of infected individuals make a full recovery within a week. About six per cent of patients end up having kidney failure (hemolytic uremic syndrome). Of these, between three to five per cent of patients will die.

Alcohol is a poison. Any amount of alcohol can produce damage to the the liver. The liver is very sensitive to alcohol. If you have had previous problems with the liver then the best thing is to avoid alcohol and acetaminophen.

The most common agent causing liver damage is acetaminophen. However, It is considered the safest medication for fevers, aches and pains, but only if taken in small recommended amounts. In large amounts, greater than those recommended, can result in the liver damage or failure. Acetaminophen overdose is a common reason for considering a transplant.

We have five vital organs – the liver, the brain, the heart, the lungs and the kidneys. The liver plays a vital role in the metabolism of fat and carbohydrates, synthesis of proteins, detoxification of poisons and storage of good nutrients. When the the liver fails, either acutely or chronically, these important functions do not occur. Thus, the person faces severe ill health. There are numerous other reasons why the liver can fail. It is impossible to discuss them all here. However, you get the idea. It is easy to damage your liver if you are not careful.

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One Reply to “What would make the liver quit working?”

  1. Dr. Bharwani:

    Further to your recent article in the Oyen Echo, I believe you overlooked one of the other major causes of liver failure – Mononucleosis.

    I contracted mono in 1971-72 at the age of approx. 21. Went from approx. 96 lbs. to 72 lbs. Was in bed with fever for total 3 ½ months. Strep throat, spleen flattened out over stomach, liver damaged, fever, etc. Even when I went back to work part time after 3 ½ months, I still had fever. They could not kill it. They did all the other tests for Hep., etc. – negative. They were suggesting a liver transplant back then but said I was in too poor condition. It took exactly 10 years, yes – 10 years to get the liver blood tests back to normal. A looong slow climb. And a big round of clapping hands from me and my doctor after 10 years when I had a normal liver blood test. Heavens – even an alcoholic could have re-grown a new liver in 6-9 months. Then in 1976 severe hashimotos thyroid with goiter, then in 1977 severe Sjogrens, then in 1978-79 premature menopause brought on by hashimotos thyroid failure. It was a long climb. And so very young to go through all this.

    I am now 62 and my health has been the pits ever since 1971-72. It never gets better. At times the liver blood tests still go funny, but not that alarming. All the other tests are still weird in that they recently did a bone marrow test, testing me for leukemia and lymphoma because of weird blood tests. They came to the conclusion that it is the Sjogrens that is causing weird blood tests. Everything else has been ruled out. Personally I think the Mono of 1971-72 still plays a big part in why I still get weird blood tests.

    But people should be warned that mononucleosis can cause liver failure in extreme cases.

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