[FULMINANT HEPATIC FAILURE IN CHILDREN]

Area of Science:

• Pediatric Hepatology
• Gastroenterology
• Public Health

Background:

• Fulminant Hepatic Failure (FHF) presents a significant challenge in pediatric care, particularly in resource-limited settings.
• Understanding the specific etiologies and clinical characteristics of FHF in children is crucial for improving outcomes.
• Previous studies have highlighted diverse causes of FHF, but pediatric-specific data from regions like Peru are less common.

Purpose of the Study:

• To investigate the etiological spectrum of FHF in a pediatric cohort.
• To describe the clinical and laboratory features associated with FHF in children.
• To determine prognostic factors and mortality rates in pediatric FHF.

Main Methods:

• Retrospective analysis of 29 pediatric patients diagnosed with FHF at the Instituto Nacional del Niño, Lima, Peru.
• Data collection included etiology, clinical presentation, laboratory values, treatment, and outcomes.
• Statistical analysis to identify correlations between clinical/laboratory findings and prognosis.

Main Results:

• Etiology remained undetermined in 11 patients; Hepatitis A virus (HAV) was the most frequent identified cause (44.4%), followed by inorganic phosphorus poisoning (27.7%).
• Mean age was 5 years and 4 months; key presenting symptoms were encephalopathy and vomiting.
• High mortality rate of 69% was observed; upper gastro-intestinal bleeding and hydroelectrolyte imbalance were common complications.

Conclusions:

• Hepatitis A virus and inorganic phosphorus poisoning are significant etiological factors for pediatric FHF in this Peruvian cohort.
• Early onset of encephalopathy after jaundice indicates a poorer prognosis.
• Short prothrombin time and elevated transaminases correlated with better prognosis, while infectious causes showed higher AST and bilirubin levels.