All issues > Volume 30(4); 1987

Original Article

J Korean Pediatr Soc. 1987;30(4):406-415. Published online April 30, 1987.

A Clinical Observation on Fulminant Hepatitis in Children.

Hoan Jong Lee¹, Jeong Kee Seo¹, Hyung Ro Moon¹

¹Department of Pediatrics, College of Medicine, Seoul National University Seoul

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.

Keywords :Fulminant hepatitis.