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A Clinical Observation on Fulminant Hepatitis in Children.

Journal of the Korean Pediatric Society 1987;30(4):406-415.
Published online April 30, 1987.
A Clinical Observation on Fulminant Hepatitis in Children.
Hoan Jong Lee, Jeong Kee Seo, Hyung Ro Moon
Department of Pediatrics, College of Medicine, Seoul National University Seoul
소아 전격성 간염의 임상적 고찰
이환정, 서정기, 문형로
서울대학교 의과대학 소아과학교실
Abstract
Twenty-seven cases of fulminant hepatitis in children were retrospectively analyzed. The overall survival rate was 11%. The interval between onset of encephalopathy and death, and that between jaundice and death were 2-26 days (median 4 days), 4-61 days (median 14 days), respectively. HBs antigenemia was detected in 24%, HAV IgM was negative in 5 patients tested, and 4 cases were suspected as non-A, non-B hepatitis Two patients, one with HBs antigenemia, and the other with only HBcAb, were considered as fulminant hepatitis in infancy transmitted vertically from HBsAg-positive but HBeAg negative mothers. The complications, encephalopathy, bleeding tendency, ascites, renal failure, electrolyte disturbance and infection, were observed in 96%, 64%, 41%, 26%, 22% and 7% respectively. Serum bilirubin concentrations decreased with the reduction of serum transaminases in 2 survived patients, but were persistently high in succumbed patients. In view of the high fatality of patients with fulminant hepatitis, it is concluded that more aggressive therapy be considered in patients with persistently high bilirubin concentrations despite decreasing serum transaminases.
Key Words: Fulminant hepatitis.


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