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Risk factors for fulminant hepatic failure and their relation with outcome in children

Nazia Latif1, Khalid Mehmood

  • 1Department of Paediatrics, Civil Hospital, Karachi.

JPMA. the Journal of the Pakistan Medical Association
|March 16, 2010
PubMed

Insights

Fulminant hepatic failure (FHF) in children is often caused by Hepatitis A. Younger age, severe encephalopathy, and specific lab values indicate a poor prognosis, highlighting the need for timely intervention.

Area of Science:

  • Pediatric Hepatology
  • Gastroenterology
  • Virology

Background:

  • Fulminant hepatic failure (FHF) presents a critical medical challenge in pediatric populations.
  • Identifying etiological factors and prognostic indicators is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the risk factors associated with fulminant hepatic failure (FHF) in children.
  • To analyze the relationship between identified risk factors and the outcomes of pediatric FHF cases.

Main Methods:

  • A descriptive case study design was employed.
  • Data from 50 pediatric patients diagnosed with FHF were retrospectively analyzed.
  • Outcomes were categorized as recovery or mortality during hospitalization.

Main Results:

  • Viral infections were the leading cause of FHF, accounting for 74% of cases, with Hepatitis A virus (HAV) in 56% and Hepatitis B virus (HBV) in 18%.
  • Non-viral etiologies included Wilson's disease (8%) and autoimmune hepatitis (2%), with 16% of cases having an undetermined cause.
  • Mortality rate was high, with 60% of patients expiring, while 40% recovered.

Conclusions:

  • Hepatitis A is the most frequent cause of FHF in the pediatric age group.
  • Factors such as age under 4 years, advanced encephalopathy, INR >4, elevated bilirubin, and decreased SGPT are associated with poor outcomes.
  • High mortality rates underscore the critical need for liver transplantation in managing pediatric FHF.
Abstract

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