Risk factors for fulminant hepatic failure and their relation with outcome in children.
OBJECTIVE
To identify the risk factors for fulminant hepatic failure (FHF) and their relation with the outcome in children.


METHODS
Descriptive case study was conducted at National Institute Of Child Health. Fifty patients having clinical and biochemical markers suggestive of FHF were included in this study and data was extracted from files, retrospectively. Their outcome was noted as expiry or recovery during hospital stay.


RESULTS
The most common etiology found was viral in origin present in thirty-seven (74%) cases. Out of them twenty-eight (56%) had HAV and nine (18%) had HBV. Thirteen (26%) patients were negative for acute serology of hepatrophic viruses, out of them four (8%) had Wilson's disease and one (2%) had autoimmune hepatitis. Etiology could not be established in eight (16%) cases. Thirty (60%) patients expired and twenty (40%) patients recovered.


CONCLUSIONS
FHF is not uncommon in children. Hepatitis A is most common cause in paediatric age group. Age less than 4 years, higher degree of encephalopathy, INR >4, higher serum bilirubin with lower SGPT has poor outcome and mortality is high without liver transplantation.
Department of Paediatrics, Civil Hospital, Karachi.
Nazia
N
Latif
Khalid
K
Mehmood
D000293:Adolescent; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006506:Hepatitis A / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D019693:Hepatitis, Autoimmune / Q000150:complications; D006527:Hepatolenticular Degeneration / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D016896:Treatment Outcome
D000410:Alanine Transaminase; D001663:Bilirubin