Nonviral or Drug-Induced Etiologies of Acute-on-Chronic Liver Failure (Autoimmune, Vascular, and Malignant)

Vascular, AIH and malignancy are relatively uncommon etiologies of ACLF. Among the vascular causes, BCS and PVT are the main causes. Anticoagulation is the mainstay of therapy but patients with liver failure may require interventional therapies and evaluation for transplantation. AIH should be considered in patients with concomitant auto immune disease and systemic symptoms. Malignant causes can be secondary to infiltration or bulky metastatic disease and have a poor prognosis with high mortality.