title: A case report of pediatric fulminant hepatitis treated with plasma diafiltration.
abstract: Plasma diafiltration (PDF) is blood purification therapy in which simple plasma exchange is performed with a membrane plasma separator while dialysate flows outside the hollow fibers. A 14-year-old boy with fulminant hepatitis underwent two sessions of PDF and one session of hemodiafiltration. We infused filtered replacement fluid for artificial kidneys at a dialysate flow rate of 600 mL/h and a replacement flow rate of 450 mL/h. We infused fresh frozen plasma (1200 mL) and 25% albumin solution (50 mL) intravenously over 8 h. Each PDF session lasted 8 h. The patient's total bilirubin, interleukin-18, and cystatin C levels decreased with treatment, and he recovered from hepatic failure. PDF may be an extremely useful blood purification therapy for pediatric fulminant hepatitis in terms of both medical economics and cytokine removal.
authors.affiliation: Department of Integrated Medicine, and Emergency and Critical Care Medicine, Akita University School of Medicine, Akita, Japan. nakaeh@doc.med.akita-u.ac.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakae
authors.forename: Toshiko
authors.initials: T
authors.lastname: Igarashi
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Tajimi
authors.forename: Atsuko
authors.initials: A
authors.lastname: Noguchi
authors.forename: Ikuko
authors.initials: I
authors.lastname: Takahashi
authors.forename: Satoko
authors.initials: S
authors.lastname: Tsuchida
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Asanuma
mesh_terms: D000293:Adolescent; D000418:Albumins / Q000627:therapeutic use; D001663:Bilirubin / Q000378:metabolism; D055316:Cystatin C; D015891:Cystatins / Q000378:metabolism; D017583:Hemodiafiltration / Q000379:methods*; D006509:Hepatitis B / Q000628:therapy*; D006801:Humans; D020382:Interleukin-18 / Q000378:metabolism; D017114:Liver Failure, Acute / Q000628:therapy*; D008297:Male; D010949:Plasma / Q000378:metabolism
chemical_list: D000418:Albumins; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D020382:Interleukin-18; D001663:Bilirubin