[Clinical features of liver failure in children].
OBJECTIVE
To analyze the etiology, clinical and laboratory characteristics of hepatic failure in 105 children.


METHODS
The clinical data of 105 children with hepatic failure treated in our hospital from January 1986 to June 2003 were retrospectively analyzed by EXCELL 2000 and t test.


RESULTS
(1)Of the 105 children with hepatic failure, 9 were cases with fulminant hepatic failure, 38 with subacute hepatic failure and 58 with chronic hepatic failure. (2)Morbidity was the highest in 7-12 years old children (43/105, 41.0%) followed by infants (30/105, 28.6%). (3)CMV infection could be confirmed in 9 infants (30.0%), etiological diagnosis was not possible in 13 infants (43.3%). Etiological diagnosis could be confirmed in children over 1 year of age, which included hepatitis B (n=22, 29.3%), Wilson's disease (n=15, 20.0%), hepatitis A (n=10,13.3%). Etiology in 21 cases (28.0%) could not be confirmed. (4)Seventy-one cases (67.6%) had ascites, 34 of them (47.9%) had spontaneous peritonitis. Thirty-five cases were complicated with other infections. The commonest complication was pulmonary infection and sepsis was the next. Fifty-one cases (48.6%) had hydroelectrolyte imbalance. Forty-eight cases (46.2%) had hepatic encephalopathy, which may be subclinical in children under three years of age. (5)The incidence of hypoglycemia was 77.2%(71/92).


CONCLUSIONS
The etiology of liver failure was related to age. CMV infection was the commonest in infants. HBV, HAV infection was the commonest in children over 1 year of age and Wilson?s disease was the next. It is necessary to prevent and manage the associated complications as early as possible such as spontaneous peritonitis, hepatic encephalopathy, hydroelectrolyte imbalance and hypoglycemia etc.
Zhu
Shi-shu
SS
Department of Pediatric Liver Diseases, The No.302 Hospital of PLA, Beijing 100039, China.
Zhang
Hong-fei
HF
Chen
Ju-mei
JM
Yang
Xiao-jin
XJ
Xu
Zhi-qiang
ZQ
Chen
Da-wei
DW
Dong
Yi
Y
Xu
Chang-jiang
CJ
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology; D006506:Hepatitis A / Q000150:complications; D006509:Hepatitis B / Q000150:complications*; D006527:Hepatolenticular Degeneration / Q000150:complications; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D007223:Infant; D017093:Liver Failure / Q000209:etiology*; D017114:Liver Failure, Acute / Q000209:etiology; D008297:Male; D010538:Peritonitis / Q000150:complications