Clinical presentation Clinical presentation is often non-specific and includes headaches, fatigue, nausea, vomiting, and abdominal discomfort. In severe cases, liver and renal impairment can occur with associated coagulopathy, encephalopathy, oliguria, and uremia. Other findings may include thrombocytopenia, microangiopathic changes, elevated INR, and leukocytosis. Liver biopsy Liver biopsy may be very helpful in confirming the diagnosis of AFLP and reveals microvesicular steatosis, inflammation of the lobular hepatocytes, and patchy hepatocellular necrosis. These findings are similar to those found in patients with Reye's syndrome and valproate toxicity.
Rapid improvement is seen postpartum.