Background: Fulminant hepatic failure is a complication of viral hepatitis and is one of the leading causes of death in hospitalized children with viral hepatitis in India.Methods: All the patients suspected to have acute viral hepatitis and/or fulminant hepatic failures with hepatic encephalopathies were included in the study and the diagnosis was made on the basis of history, clinical examination including a detailed neurological examination. Triage scoring, Glasgow coma scale, encephalopathy grading were recorded at the time of admission and necessary investigations were carried out.Results: The occurrence of acute viral hepatitis and fulminant hepatic failure was 200 (2.004%) and 40 (0.401%) respectively during study period. Highest occurrence of 35.50% in the age group of 4-6 years, yellowish discoloration of the eyes or the urine was the most common presenting complaint. Only 45 % of the children who had fulminant hepatic failure survived and mortality was found to be 100% in those children who had grade 4 hepatic encephalopathy. Mortality was higher in those children who had duration of more than 10 days between the onset of jaundice and encephalopathy. Mortality was higher in those with prothrombin time between 41 to 50 seconds and with serum ammonia level more than 200 mmol/l. Hepatitis A virus was the most common cause of fulminant hepatic failure and Hepatitis E virus with hepatic encephalopathy was associated with 100 % mortality.Conclusions: Hepatitis A infection though associated with a good prognosis, younger age group (< 6 years) and co infection with Hepatitis E virus have a poor prognosis. Good hygiene practices and early immunization could be a step towards the prevention of Hepatitis A infection.
Fulminant hepatic failure in pregnant women: acute fatty liver or acute viral hepatitis?
