Severe hepatocellular dysfunction

Patients with severe hepatocellular dysfunction may have elevated PA levels. Thus far this is unexplained. 

The two most serious complications of acute viral hepatitis found in J patients such as Percy Veere are massive hepatic necrosis leading to ful- minant liver failure and the eventual development of chronic hepatitis. Both complications are rare in acute viral hepatitis type A, however, suggesting that acetaminophen toxicity may have contributed to Percy s otherwise unexpectedly severe hepatocellular dysfunction and early hepatic encephalopathy. 

Injection of ethanol into the liver to treat hepatocellular carcinoma commonly causes severe pain, fever, and hepatic dysfunction there can also be pleural effusion, pneumothorax, ascites, vasovagal reaction, transient hypotension, myoglobinuria, and portal thrombosis. Fatal massive hepatic necrosis distant from the injection site has also been attributed to this treatment (SEDA-18, 377). 

Ketoconazole produces generalized hepatocellular necrosis or milder forms of hepatic dysfunction in 1% to 2% of patients treated for fungal infections. This reaction is fatal in high numbers of patients infected with the human immunodeficiency virus. The onset is usually early in therapy, although it can be delayed until several months into therapy. In rmmune-compromised patients in whom ketoconazole is used for long periods of time, special care should be taken to watch for changes in liver function. ... 

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