[Fulminant hepatic failure in children].
We report the clinical characteristics and course of 38 children with fulminant liver failure. A viral etiology was demonstrated in 19 patients out of 25 with serologic screening (virus A in 17 patients, B in 2 patients). One patient had toxic liver damage from ingestion of a caustic substance. Mean age was 4 years and 6 months. Jaundice was present in all but 2 patients at admission. Encephalopathy developed at a mean of 13 days and 17 children were admitted with stage 3 or 4 coma. Evidence of severe liver failure was present in every patient. A lower prothrombin time and higher bilirrubin concentration were shown by non survivors. Hypoglycemia developed in 37% of patients, seizures in 37%, gastrointestinal bleeding in 45%, respiratory failure in 32% and severe infection in 32%. Overall mortality rate was 42% raising to 83% in patients with stage 3 coma at admission. Thus, although the etiology of fulminant liver failure differs in children as compared to adults, mortality rate and complications are similar.
Cordero
J
J
Unidade de Tratamiento Intensivo, Hospital Luis Calvo Mackenna, Santiago de Chile.
Baeza
J
J
Zacarías
J
J
Brinck
P
P
Vega
E
E
Maureira
E
E
Latorre
J
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
Falla hepatica fulminante en niños.