Fulminant hepatic failure: etiology, viral markers and outcome

Bendre, Sachin V. ; Bavdekar, Ashish R. ; Bhave, Sheila A. ; Pandit, Anand N. ; Chitambar, S. D. ; Arankalle, V. A. (1999) Fulminant hepatic failure: etiology, viral markers and outcome Indian Pediatrics, 36 . pp. 1107-1112. ISSN 0019-6061

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Objective: To investigate the etiology and outcome of fulminant hepatic failure (FHF) in children. Setting: Hospital based descriptive. Methods: 36 children (22 males and 14 females) presenting with FHF over a period of one year were investigated. The ages ranged from 1.5 to 9 years. FHF was defined as occurrence of encephalopathy within eight weeks of onset of jaundice with no evidence of pre-existing liver disease. Detailed history, clinical examination, routine biochemical parameters and relevant diagnostic tests were carried out. Viral markers studied were anti HAV-IgM, HBsAg, anti HBc-IgM, anti-HCV and anti HEV-IgM. Results: A viral etiology could be established in 22 children (61.1%). Hepatitis A (n=12), Hepatitis B (n=3), Hepatitis A and B (n=2), and Hepatitis A and E (n=4). Two children had enteric fever (1 with associated HEV), 2 children had Wilson's disease, 1 child had Indian Childhood Cirrhosis (ICC) and 2 children had drug induced hepatitis. Etiological diagnosis was not possible in 8 children (22%). Fourteen children (39%) died. Poor outcome was associated with spontaneous bleeding, raised prothrombin time, lower transaminases and higher bilirubin on admission. Conclusion: Viral hepatitis is the commonest cause of FHF in children. HAV alone or in combination is responsible for upto 50% of all FHF in children. Chronic liver disease can also present as FHF. Etiological diagnosis is not possible to upto one-fourth of all cases.

Item Type:Article
Source:Copyright of this article belongs to Indian Academy of Pediatrics.
Keywords:Fulminant Hepatic Failure; Viral Hepatitis
ID Code:59753
Deposited On:07 Sep 2011 14:34
Last Modified:07 Sep 2011 14:34

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