Hypoxic hepatitis related to profound anemia: How low can you go?

Okas, Andrew; Kowalczyk, Joseph; Stein, Robert B.; Lee, Douglas; Berkelhammer, Charles

doi:10.1111/j.1572-0241.2001.05381.x

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…Few cases of HH have been reported as a consequence of extreme anaemia without hypovolaemia. To our knowledge only two cases have been reported with haemoglobin levels below 3 g/dl . In this condition, oxygen delivery to the liver falls to critical levels despite increase in cardiac output and liver blood flow.…”

Section: Atypical Course Of Hypoxic Hepatitis and Particular Circumstmentioning

confidence: 87%

Hypoxic hepatitis

Henrion

2011

Liver International

173

143

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Hypoxic hepatitis (HH), an acute liver injury also known as 'ischaemic hepatitis' or 'shock liver', is frequently observed in intensive care units. HH is heralded by a massive but transient rise in serum aminotransferase activities caused by anoxic necrosis of centrilobular liver cells. Cardiac failure, respiratory failure and toxic-septic shock are the main underlying conditions accounting for more than 90% of cases, but HH may also occur in other circumstances. Until recently, liver ischaemia, i.e. a drop in hepatic blood flow, was considered the leading, and even the sole, hemodynamic mechanism responsible for HH, and it was generally held that a shock state was required. In reality, other hemodynamic mechanisms of hypoxia, such as passive congestion of the liver, arterial hypoxaemia and dysoxia, play an important role while a shock state is observed in only 50% of cases. Accordingly, 'ischaemic hepatitis' and 'shock liver' are misnomers. Therapy of HH depends primarily on the nature of the underlying condition. The prognosis is poor, with more than half of patients dying during the hospital stay.

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Section: Atypical Course Of Hypoxic Hepatitis and Particular Circumstmentioning

confidence: 87%

Hypoxic hepatitis

Henrion

2011

Liver International

173

143

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“…Reduced oxygen delivery to the liver due to severe hypoxemia, or due to severe anemia without impaired hepatic blood flow, are rare causes of this condition [12][13][14][15]. The diagnostic criteria for ischemic hepatitis include markedly elevated liver enzymes in the absence of a viral infection or chemical toxins, followed by a return to normal levels over a period of several days to a week [11].…”

Section: Discussionmentioning

confidence: 99%

Hepatic involvement in perinatal asphyxia

Tarcan

Tiker

Güvenir

et al. 2007

The Journal of Maternal-Fetal & Neonatal Medicine

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“…HH related to severe anemia was first described by Okras et al, which was followed by a study by Henrion suggesting that true shock is absent in up to half of the cases of HH. 5,8 Apart from ischemia, several studies have also proposed the effect of free radical injury from reperfusion as a contributing factor in HH. This might also have been a contributing factor in the development of HH in our patient because giving intravenous fluids was the likely precipitant of HH.…”

Section: Discussionmentioning

confidence: 99%

Severe Pernicious Anemia Predisposing to Hypoxic Hepatitis

et al. 2019

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Hypoxic hepatitis or ischemic hepatitis is most commonly encountered in critical care patients, most of whom have shock states secondary to cardiac or respiratory failure. We report a case of severe pernicious anemia predisposing to hypoxic hepatitis that had a good prognosis with simple treatment. Care should be taken in management of severe anemia, interpretation of serum vitamin B12 levels after blood transfusion, and the use of intravenous fluids.

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Hypoxic hepatitis related to profound anemia: How low can you go?

Cited by 10 publications

References 5 publications

Hypoxic hepatitis

Hypoxic hepatitis

Hepatic involvement in perinatal asphyxia

Severe Pernicious Anemia Predisposing to Hypoxic Hepatitis

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