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 |
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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.
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Key Words:
Fulminant hepatitis. |
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