Our Experience with Fulminant Hepatic Failure in Turkish Children: Etiology and Outcome

[Guest guest]

Journal of Tropical Pediatrics

Volume 49, Issue 6, December 2003: pp. 367-370

Article

Our Experience with Fulminant Hepatic Failure in Turkish Children: Etiology

and Outcome

Sema Aydo[gbreve]du1, Funda Özgenç1, Serap Yurtsever1, Sezin

A[scedil][inodot]k Akman1, Yaman Tokat2 and Ra[scedil]it Vural

Ya[gbreve]c[inodot]1

1Department of Pediatrics, Division of Pediatric Gastroenterology and

Nutrition, Ege University, Turkey

2Department of Surgery, Division of Pediatric Gastroenterology and

Nutrition, Ege University, Turkey

Fulminant hepatic failure is a rare and devastating event during childhood.

The etiology of liver failure is reported to change according to age and

geographical location. We aimed to investigate, retrospectively, causes and

outcome of fulminant hepatic failure in Turkish children. Thirty-four

children with fulminant hepatic failure were analysed by means of etiology

and outcome. Etiological factor, clinical presentation, encephalopathy stage

and biochemical parameters were correlated with outcome. Acute viral

hepatitis was detected in 12 cases (35.2 per cent) and hepatitis A was the

most commonly detected cause among cases with fulminant hepatic failure (n =

9, 26.4 per cent). Hepatitis B and non A-E infection were diagnosed in two

(5.8 per cent) and one (2.9 per cent) cases, respectively. 's disease

was defined in four patients (12.5 per cent). Budd-Chiari syndrome (2.9 per

cent), autoimmune hepatitis (2.9 per cent) and mushroom poisoning (2.9 per

cent) were other detected causes of fulminant hepatic failure in this group.

No viral, metabolic, toxic or anatomic reason could be detected in the

remaining 15 (44.1 per cent) patients and they were evaluated as

cryptogenic. Mortality was 67.6 per cent (23 cases). Encephalopathy grade,

total and indirect bilirubin levels were found to be significantly higher in

patients who died (p = 0.004, p = 0.03, p = 0.04). Seven patients could have

been transplanted (two cadavaric, five living related) and the mortality of

this group was 28.5 per cent (n = 2). It was concluded that fulminant

hepatitis A virus (HAV) infection is the most common detectable cause of

fulminant hepatic failure in Turkish children.

[Guest guest]

Journal of Tropical Pediatrics

Volume 49, Issue 6, December 2003: pp. 367-370

Article

Our Experience with Fulminant Hepatic Failure in Turkish Children: Etiology

and Outcome

Sema Aydo[gbreve]du1, Funda Özgenç1, Serap Yurtsever1, Sezin

A[scedil][inodot]k Akman1, Yaman Tokat2 and Ra[scedil]it Vural

Ya[gbreve]c[inodot]1

1Department of Pediatrics, Division of Pediatric Gastroenterology and

Nutrition, Ege University, Turkey

2Department of Surgery, Division of Pediatric Gastroenterology and

Nutrition, Ege University, Turkey

Fulminant hepatic failure is a rare and devastating event during childhood.

The etiology of liver failure is reported to change according to age and

geographical location. We aimed to investigate, retrospectively, causes and

outcome of fulminant hepatic failure in Turkish children. Thirty-four

children with fulminant hepatic failure were analysed by means of etiology

and outcome. Etiological factor, clinical presentation, encephalopathy stage

and biochemical parameters were correlated with outcome. Acute viral

hepatitis was detected in 12 cases (35.2 per cent) and hepatitis A was the

most commonly detected cause among cases with fulminant hepatic failure (n =

9, 26.4 per cent). Hepatitis B and non A-E infection were diagnosed in two

(5.8 per cent) and one (2.9 per cent) cases, respectively. 's disease

was defined in four patients (12.5 per cent). Budd-Chiari syndrome (2.9 per

cent), autoimmune hepatitis (2.9 per cent) and mushroom poisoning (2.9 per

cent) were other detected causes of fulminant hepatic failure in this group.

No viral, metabolic, toxic or anatomic reason could be detected in the

remaining 15 (44.1 per cent) patients and they were evaluated as

cryptogenic. Mortality was 67.6 per cent (23 cases). Encephalopathy grade,

total and indirect bilirubin levels were found to be significantly higher in

patients who died (p = 0.004, p = 0.03, p = 0.04). Seven patients could have

been transplanted (two cadavaric, five living related) and the mortality of

this group was 28.5 per cent (n = 2). It was concluded that fulminant

hepatitis A virus (HAV) infection is the most common detectable cause of

fulminant hepatic failure in Turkish children.