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[Fulminant and subfulminant viral hepatitis]
1Service d'Hépatologie, INSERM (U-24), Hôpital Beaujon, Clichy.
La Revue Du Praticien
|June 21, 1990
Summary
Fulminant hepatitis, often caused by viral hepatitis B, has a high mortality rate. Early hospitalization for severe acute hepatitis can prevent progression and improve outcomes.
Area of Science:
- Hepatology
- Virology
- Critical Care Medicine
Context:
- Fulminant and subfulminant hepatitis are severe forms of acute liver inflammation.
- Characterized by prothrombin levels <50% and hepatic encephalopathy.
- Most commonly caused by acute viral hepatitis, particularly Hepatitis B virus.
Purpose:
- To describe the clinical manifestations, prognosis, and management of fulminant hepatitis.
- To highlight the importance of early intervention and the role of liver transplantation.
Summary:
- Key features include jaundice, encephalopathy, low factor V, circulatory changes, and acute kidney injury.
- Mortality is high (75%), influenced by the causative virus and factor V levels.
- Avoid coagulant fractions and sedatives; liver transplantation offers a survival benefit (60%).
Impact:
- Early hospitalization for severe acute hepatitis (prothrombin <50%, no encephalopathy) significantly reduces mortality.
- Proactive management can prevent progression to fulminant or subfulminant disease.
- Understanding prognostic factors like factor V levels is crucial for patient care.