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Acute hepatic failure among hospitalized Thai children

Yong Poovorawan1, Voranush Chongsrisawat, Fakrudeen Shafi

  • 1Chulalongkorn University Hospital, Bangkok, Thailand. Yong.P@chula.ac.th

The Southeast Asian Journal of Tropical Medicine and Public Health
|May 21, 2013
PubMed

Insights

Causes of acute hepatic failure (AHF) in Thai children remain largely unknown, with dengue fever a suspected factor in some cases. This study highlights the critical need for further research into AHF etiology and outcomes in pediatric populations.

Area of Science:

  • Pediatric Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute hepatic failure (AHF) is a rare but severe condition in children.
  • Identifying the causes of AHF is crucial for effective management and prognosis.
  • Etiology of AHF in Southeast Asian pediatric populations requires further investigation.

Purpose of the Study:

  • To determine the causes and outcomes of acute hepatic failure in Thai children.
  • To investigate the potential role of infections, including dengue fever, in pediatric AHF.
  • To describe the clinical presentation and mortality associated with AHF in this cohort.

Main Methods:

  • A hospital-based study was conducted from June 2002 to December 2006.
  • Eleven children aged 1-15 years diagnosed with acute hepatic failure were included.
  • Etiological investigations included viral hepatitis markers, autoimmune workup, and assessment for other infections.

Main Results:

  • The etiology of AHF remained unknown in 6 out of 11 children.
  • Hepatitis B virus, infection-associated hemophagocytic syndrome, and Wilson's disease were identified as causes in one child each.
  • Dengue fever was suspected in 2 children; jaundice and encephalopathy were common presenting symptoms.
  • The mortality rate due to AHF was high, with 5 out of 11 children dying.

Conclusions:

  • The majority of pediatric AHF cases in this Thai cohort had an undetermined cause.
  • Dengue infection is a potential, yet understudied, contributor to AHF in children.
  • Further research is essential to elucidate the specific causes of AHF and improve outcomes, especially concerning dengue fever.
  • No liver transplantations were performed, indicating limited advanced treatment options within the study period.

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