, Volume 29, Issue 5, pp 177-180
Date: 31 Oct 2010

Defining ‘acute on chronic liver failure’: an identity crisis!

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‘We should be careful to get out of an experience only the wisdom that is in it and stop there; lest we be like the cat that sits down on a hot stove lid. She will never sit down on a hot stove lid again—and that is well; but also she will never sit down on a cold one anymore.’

Mark Twain

1835–1910

What’s in the name?

A clinical syndrome represents a typical constellation of physical and laboratory findings that may be seen as a part of one or more primary disease processes. Clinical syndromes have often been born out of astute observations by experienced clinicians with sharp observation and pattern recognition skills. Defining clinical syndromes is helpful since familiarity with a particular clinical pattern leads clinicians along the ‘problem-solving’ pathway to arrive at a specific diagnosis and plan an appropriate management in future patients. Description of a new clinical syndrome naturally attracts attention and ‘case definition’ is an essential first step in any focused investigat ...