fulminant hepatitis

Introduction

Appearance of severe liver injury with coagulopathy & hepatic encephalopathy within 8 weeks of the onset of hepatitis in a previously healthy individual.

Etiology

• hepatitis B
• hepatitis A
• cryptogenic hepatitis (non A, B or C)
• drug-induced liver disease
• parvovirus B19

Epidemiology

• 2000 cases yearly in USA
• 6% of liver-related deaths

Complications

• mortality is 30-85% depending upon cause

Management

• drug-induced fulminant hepatitis carries a very poor prognosis, except for acetaminophen-induced in which spontaneous recovery generally occurs
• liver transplantation
  • refer early
  • indications:
    • spontaneous recovery is unlikely
    • transplant recovery is probable
• treat infections
• treat hemodynamic abnormalities
• minimize brain edema

More general terms

• acute hepatitis

Additional terms

• drug/toxin-induced hepatitis