Acute liver failure is a rare presentation to emergency departments (EDs) in the UK, leading to around 400 admissions per year.

Paracetamol overdose accounts for in excess of 70% of cases in the UK, whereas viral hepatitis is the most common cause worldwide [1-2].

Mortality is exceptionally high and ranges from 60-90%. Paracetamol and hepatitis A have a better prognosis compared to other causes.

Learning bite

Paracetamol is the commonest cause of acute liver failure in the developed world.

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