title: [Analysis of clinical characteristics of hypoxic hepatitis in children].
abstract: OBJECTIVE
  To explore the etiology and clinical characteristics of hypoxic hepatitis (HH) in children.
  
  
  METHODS
  Clinical data of 7 patients with HH in Shenzhen Children's Hospital from January 2011 to March 2014 were retrospectively reviewed.
  
  
  RESULTS
  Seven cases diagnosed as HH, age from 4 months to 11 years, were admitted to pediatric intensive care unit (PICU), and accounted for 0.32% of patients in PICU during the same period. The primary causes of HH were respiratory failure and cardiac shock caused by severe hand-foot-and-mouth disease, fulminant myocarditis, infant muggy syndrome . Serologic tests for hepatitis B virus, hepatitis C virus, as well as serum antibody and DNA for Epstein-Barr virus and cytomegalovirus were all negative. There was an increase of alanine aminotransferase (ALT) (≥20 time supper limit of normal (ULN), the highest ALT was more than 130 times ULN in all the patients, which was decreased to 2 times ULN from peak within 10 days. There was a significant relationship between ALT and aspartate aminotransferase(AST)in 3 cases(r=1.000, 1.000, and 0.833, respectively, P<0.05), ALT and lactate dehydrogenase (LDH)in 2 cases(r=1.000 and 0.886, respectively, P<0.05), ALT and blood urea nitrogen(BUN)in 1 case(r=1.000, P<0.05), and ALT and creatine kinase(CK)in 1 case(r=0.964, P<0.05). The ALT, AST and LDH returned to normal soon after the primary diseases were controlled.
  
  
  CONCLUSIONS
  Severe heart failure, hypoxemia, shock, etc. are the leading primary diseases causing HH. The sharp increase in ALT, AST and LDH is the typical laboratory manifestion in HH after the onset, which may decline to normal shortly after the treatment, sometimes complicated with reversible change in BUN or CK.
authors.affiliation: Department of Gastroenterology, Shenzhen Children's Hospital, Shenzhen 518038, China.
authors.forename: Huabo
authors.initials: H
authors.lastname: Cai
authors.forename: Baoxing
authors.initials: B
authors.lastname: Huang
authors.forename: Zhongsheng
authors.initials: Z
authors.lastname: Zhu
authors.forename: Dongling
authors.initials: D
authors.lastname: Dai
authors.forename: Shaoming
authors.initials: S
authors.lastname: Zhou
mesh_terms: D000410:Alanine Transaminase; D000818:Animals; D001219:Aspartate Aminotransferases; D002648:Child; D002675:Child, Preschool; D003402:Creatine Kinase; D006333:Heart Failure; D006505:Hepatitis; D004854:Herpesvirus 4, Human; D006801:Humans; D000860:Hypoxia; D007223:Infant; D007770:L-Lactate Dehydrogenase; D012131:Respiratory Insufficiency; D012189:Retrospective Studies
chemical_list: D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase