Fulminant Hepatic Failure

Trey, Charles; Lipworth, Leslie; Chalmers, T. C.; Davidson, Charles S.; Gottlieb, Leonard S.; Pópper, Hans; Saunders, S. J.

doi:10.1097/00132586-196906000-00036

Cited by 194 publications

(252 citation statements)

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“…An informed consent was taken from all the AVH patients and relatives of the FHF patients. Diagnosis of FHF was based on standard clinical and biochemical criteria [18]. As a large proportion of FHF cases were observed to be non-viremic [17], stool samples were collected from 3/5 patients with FHF.…”

Section: Clinical Specimensmentioning

confidence: 99%

Hepatitis E virus from India exhibits significant amino acid mutations in fulminant hepatic failure patients

2012

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In India, hepatitis E virus (HEV) is the predominant cause of acute viral hepatitis (AVH) and fulminant hepatic failure (FHF) among pregnant women and adults. The present study evaluates association, if any, of the mutations in the viral genome with disease outcome. Ten genotype-1 complete genomes (five each from AVH and FHF patients) were sequenced. Phylogenetic analysis showed a distinct cluster including all five FHF-HEV sequences from western India (present study), one FHF isolate from northern India, and one AVH isolate detected in 2010 (present study). HEV genotype-1 sequences from fulminant cases exhibited 150 significantly different (p ≤ 0.05) nucleotide substitutions when compared to all genotype-1-AVH sequences as well as isolates from the Indian subcontinent. At six positions, all FHF sequences showed identical substitutions (1 non-synonymous). Six amino acid changes in ORF1; F179S, A317T, T735I, L1110F, V1120I, and F1439Y were significantly associated with HEV-type-1 FHF. The data suggests that the nucleotide substitutions recorded and/or L1110F and V1120I amino acid substitutions in helicase domain may play important role in determining outcome of HEV infection.

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Section: Clinical Specimensmentioning

confidence: 99%

Hepatitis E virus from India exhibits significant amino acid mutations in fulminant hepatic failure patients

2012

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“…1 Hepatitis viruses are the most common cause of FHF, followed by hepatotoxic drugs. The cause in some patients cannot be identified.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of TT virus in patients with fulminant hepatic failure in Japan

et al. 1999

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A novel virus (TT virus) was isolated from patients with posttransfusion hepatitis of unknown etiology. We studied the prevalence of TT virus in 26 patients with fulminant hepatic failure without risk factors, including blood transfusion, and also examined 106 healthy blood donors as controls. We assayed serum TT virus DNA by seminested polymerase chain reactions and also examined the genotypes of this virus. Serum was obtained at admission from patients with fulminant hepatic failure. Serum samples at admission from seven (27%) of the 26 patients were positive for TT virus DNA. There were no differences in clinical findings, duration from onset to coma, or results of laboratory tests in patients with and without TT virus DNA. However, all 7 patients with TT virus died, whereas 9 of the 19 patients without TT virus died. The outcome for patients with fulminant hepatic failure and TT virus was significantly worse than for patients without the virus (P = 0.0227). TT virus was also detected in 29 (27%) of the 106 healthy blood donors. The genotype of the TT virus was mainly 1a in both groups. There were no differences in the rate of positivity and the genotypes of TT virus between patients with fulminant hepatic failure and healthy blood donors. TT virus infection may not cause severe hepatitis, such as fulminant hepatic failure, but it may indicate a poor outcome in such patients.

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“…5 The patient gradually improved with artificial liver support and prednisolone administration. As the prednisolone dosage was gradually being decreased, he began to show spiking fever of unknown origin.…”

Section: Case Reportmentioning

confidence: 93%

Small-bowel hemorrhage caused by cytomegalovirus vasculitis following fulminant hepatitis

Hasegawa

Ogawa

et al. 2002

Journal of Gastroenterology

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We describe life-threatening vasculitis of the small bowel following fulminant hepatitis. A 35-year-old man was admitted to our hospital due to consciousness disturbance and jaundice. He was diagnosed with fulminant hepatitis, and recovered after intensive medical care that included corticosteroid administration and artificial liver support. During reduction of the dosage of steroid, massive gastrointestinal hemorrhage occurred from the upper jejunum, revealed by arteriography. The hemorrhage could not be stopped, so a portion of the ileum, including the bleeding point, was excised. However, the intestinal hemorrhage continued from several small ulcers remaining outside the resected area. Pathological findings revealed an ulcerative region that was diagnosed as cytomegalovirus (CMV) vasculitis. His serum level of CMV (measured by real-time-detection polymerase chain reaction [PCR]) was high. Ganciclovir therapy was started, and manifestations of the CMV infection improved. In addition to CMV, PCR assay for hepatitis A virus (HAV), HBV, HCV, Epstein-Barr virus (EBV), human herpes virus-6 (HHV-6), and herpes simplex virus (HSV) was performed, but no viruses other than CMV were detected. We are the first to report such a case. We conclude that the possibility of CMV enteritis should be considered when patients present with unexplained fever and gastrointestinal hemorrhage following fulminant hepatitis, and we conclude that the early administration of ganciclovir should be considered.

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Fulminant Hepatic Failure

Cited by 194 publications

References 0 publications

Hepatitis E virus from India exhibits significant amino acid mutations in fulminant hepatic failure patients

Hepatitis E virus from India exhibits significant amino acid mutations in fulminant hepatic failure patients

Prevalence of TT virus in patients with fulminant hepatic failure in Japan

Small-bowel hemorrhage caused by cytomegalovirus vasculitis following fulminant hepatitis

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