Acute, Fatal Hepatic Failure Presenting with Psychiatric Symptoms
LEO R. ZACHARSKI M.D.1,
EDWARD M. LITIN M.D.2,
DONALD W. MULDER M.D.3, , and
JAMES C. CAIN M.D.4
1 Department of medicine, Dartmouth Medical School, Dartmouth-Hitchcock Affiliated Hospitals, Veterans Administration facility, White River Junction, Vt. 05001
2 Section of psychiatry, Mayo Clinic and Mayo Foundation. Rochester, Minn.
3 Section of neurology, Mayo Clinic and Mayo Foundation. Rochester, Minn.
4 Section of medicine, Mayo Clinic and Mayo Foundation. Rochester, Minn.
Mental disturbances are a common con-comitant of liver disease and are usually superimposed on gross evidence of liver failure. The authors describe two patients who had rapidly progressive and ultimately fatal liver disease but initially manifested only psychiatric symptoms. In neither was there any suggestion of liver disease in the history or in the clinical data until shortly before death.
