title: Acute liver failure in children: observations in Vitória, Espírito Santo State, Brazil.
abstract: In this communication we report 46 cases of acute liver failure in children diagnosed at the Hospital Infantil Nossa Senhora da Glória in Vitória, E Santo. Serology for IgM anti-HAV, IgM anti-HBc, HbsAg, anti-HCV and biochemical tests were performed in all cases in a routine laboratory. The M/F ratio was 1.1:1 and the mean age was 4.7 +/- 3.2 years, without gender difference. Anti-HAV IgM+ in 38 (82.6%) cases, anti-HbcIgM+ in two (4.3%) cases and 6 (13.1%) cases were negative for all viral markers investigated. Anti-HCV+ in one anti-HAV IgM+ case. HbsAg+ in two anti-HbcIgM+ and in two HAVIgM+ cases. Among the six A, B and C negative cases, four (8.6%) did not have the suspected exogenous intoxication. Mortality was 50%, without gender or age differences. These results demonstrate that HAV infection is the main etiology of acute liver failure in children in Brazil, confirming that, although it is a self limited, relatively mild illness, it can cause serious and even fatal disease. The observation of four cases without A, B and C viral markers and no history of exogenous intoxication, agree with the observation of non A-E acute sporadic hepatitis in Northeastern Brazil.
authors.affiliation: Hospital Infantil Nossa Senhora da Glória, Vitória ES, Brasil.
authors.forename: Sandra F
authors.initials: SF
authors.lastname: Moreira-Silva
authors.forename: Diana O
authors.initials: DO
authors.lastname: Frauches
authors.forename: Alba L
authors.initials: AL
authors.lastname: Almeida
authors.forename: Haydée F M S
authors.initials: HF
authors.lastname: Mendonça
authors.forename: Fausto Edmundo L
authors.initials: FE
authors.lastname: Pereira
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000401:mortality* / Q000821:virology; D008297:Male