title: Cryptogenic fulminant hepatic failure in infancy: report of 2 cases with unique vascular obstructive changes in native livers.
abstract: Although the causes of fulminant hepatic failure (FHF) remain cryptogenic in many cases, a few reports have reviewed the pathological findings of native livers to evaluate the etiology. We report 2 cases of infantile cryptogenic FHF with unique vascular obstructive changes in the native livers. Clinically, it was notable that these 2 patients developed FHF very early in life, at 2 months and 5 months of age, respectively. One patient died from chronic rejection associated with hepatic veno-occlusive disease 4 months after transplantation. Histologically, hepatocytes in the native livers were completely destroyed in both patients, and vascular findings revealed obstruction of central veins in 1 patient and obstruction of portal veins in the other patient. Although the pathogenesis of vascular obstructions is not yet understood, this study suggests that an obstructive vascular event may be a contributing etiologic factor of FHF in infancy.
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shimojima
authors.forename: Rie
authors.initials: R
authors.lastname: Shibata
authors.forename: Ken
authors.initials: K
authors.lastname: Hoshino
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawachi
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanabe
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
authors.forename: Motohide
authors.initials: M
authors.lastname: Shimazu
authors.forename: Michiie
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D001808:Blood Vessels / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008102:Liver Circulation / Q000502:physiology*; D017114:Liver Failure, Acute / Q000401:mortality / Q000473:pathology / Q000503:physiopathology*; D016031:Liver Transplantation; D008297:Male