title: Survival rate in children with fulminant hepatitis improved by a combination of twice daily plasmapheresis and intensive conservative therapy.
abstract: Six of seven children with fulminant hepatitis (FH) were treated with a combination of twice daily plasmapheresis and intensive conservative therapy including special amino acid solution, glucagon-insulin therapy, dexamethasone, and so on. The remaining child was treated with intensive conservative therapy only because his condition was not so severe, in spite of being diagnosed as having fulminant hepatitis. Although five patients with biopsy-documented bridging hepatic necrosis or confluent hepatic necrosis in the acute phase made recoveries, the remaining two with massive hepatic necrosis died (the overall survival rate was 71%). The prognostic factors were considered to be the degree and pattern of liver cell necrosis, the degree of coma, and the etiology. The combination of twice daily plasmapheresis and intensive conservative therapy was effective for these pediatric patients with fulminant hepatitis, except those with massive hepatic necrosis.
authors.affiliation: Department of Pediatrics, University of Tsukuba, Ibaraki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shin
authors.forename: Y
authors.initials: Y
authors.lastname: Nagai
authors.forename: C
authors.initials: C
authors.lastname: Hirano
authors.forename: N
authors.initials: N
authors.lastname: Kataoka
authors.forename: I
authors.initials: I
authors.lastname: Ono
authors.forename: E
authors.initials: E
authors.lastname: Yamamura
authors.forename: C
authors.initials: C
authors.lastname: Moriyama
authors.forename: Y
authors.initials: Y
authors.lastname: Horigome
authors.forename: T
authors.initials: T
authors.lastname: Ehara
authors.forename: T
authors.initials: T
authors.lastname: Kamoda
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006501:Hepatic Encephalopathy / Q000401:mortality / Q000628:therapy*; D006505:Hepatitis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D010288:Parenteral Nutrition; D010956:Plasmapheresis / Q000379:methods*; D015996:Survival Rate