Fulminan karaciğer yetmezliği ile seyreden viral hepatitli olguların değerlendirilmesi

Abstract

Background and Aims: Fulminant hepatic failure, a severe and acute hepatic injury that manifests as a sudden impairment of hepatic synthetic functions and progresses accompanied with encephalopathy in patients with normal hepatic functions, is most commonly caused by viral hepatitis in Turkey. This study analyzed patients with a fulminant clinical course of viral hepatitis followed up in our clinic. Metarial and Methods: Patients with viral hepatitis who were diagnosed with fulminant hepatitis between 1991 and 2012 were retrospectively analyzed. Fulminant hepatic failure that occurred within the first 8 weeks after the onset of the first symptoms and/or failure that occurred within 2 weeks following jaundice was accepted as acute failure, whereas failure that occurred within a longer period was considered as subacute failure. Only demographic data and outcomes of the cases monitored between 1991 and 1997 were available. Results: Twenty-eight (58%) patients were female and 20 were male, and the age range was 15–70 years (mean, 35.3 years). The shortest and longest symptom onset durations were 2 and 21 days, respectively (mean, 7.4 days). Acute cases (80%) were commonly found, and the most common type of viral hepatitis was hepatitis B (39%). Eight patients were negative for hepatitis markers, and they had not taken any drug, plant, or toxic substance (31%); they died on the first day of hospitalization. Twelve (25%) patients with a diagnosis of fulminant hepatitis recovered by supportive therapy. When the distribution of cases by years was analyzed, it was observed that the number of cases significantly decreased as the years progressed. Conclusion: Fulminant hepatitis is a difficult clinical entity to cure and generally progresses to mortality. The mortality rate of the disease can be reduced depending on early diagnosis and treatment with supportive therapy, including intensive care unit treatment and performing hepatic transplantation.