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Fulminant hepatitis in children: report of 12 cases
I R Friedland1, M Zuckerman, U K Kala
1Department of Paediatrics, Baragwanath Hospital, Johannesburg, South Africa.
Insights
Fulminant hepatitis in children, though rare, carries a high mortality rate. This study details twelve cases, highlighting encephalopathy and jaundice as key indicators of this severe liver condition.
Area of Science:
- Pediatric Hepatology
- Viral Hepatitis Research
- Critical Care Medicine
Background:
- Acute viral hepatitis is typically benign in childhood.
- Fulminant hepatitis is an infrequent but severe complication.
- High mortality rates are associated with fulminant hepatitis.
Purpose of the Study:
- To describe the clinical features and outcomes of childhood fulminant hepatitis.
- To identify key indicators and mortality associated with this condition.
- To analyze the etiological agents of fulminant hepatitis in pediatric cases.
Main Methods:
- Retrospective case series analysis.
- Review of twelve pediatric cases of fulminant hepatitis over four years.
- Clinical data collection including onset, symptoms, and laboratory findings.
Main Results:
- Six cases were hepatitis A, five hepatitis B, and one non-A non-B hepatitis.
- Encephalopathy was a common feature, typically appearing within two weeks.
- In fatal cases, the median illness duration was 19 days; deep jaundice, prolonged prothrombin time, and elevated serum ammonia were invariable.
Conclusions:
- Fulminant hepatitis in children, while uncommon, presents with severe symptoms and a high mortality risk.
- Early recognition of encephalopathy and biochemical markers is crucial.
- Prompt medical intervention is necessary for the few survivors.
Abstract:
Twelve cases of childhood fulminant hepatitis seen over a 4-year period are described. Six had hepatitis A, five hepatitis B and one non-A non-B hepatitis. Encephalopathy, the cardinal feature of fulminant hepatitis, was usually evident within 2 weeks of onset of illness, and the median duration of illness in fatal cases was 19 days. Deep jaundice, prolongation of the prothrombin time and raised serum ammonia were invariable. Eight children died and the four survivors were critically ill before recovering. Acute viral hepatitis is generally a benign illness in childhood. Although infrequently recorded, fulminant hepatitis may, however, ensue and is associated with a high mortality.