Fulminant hepatic failure in children and adolescents in Northern Brazil

Fonseca, José Carlos Ferraz da; Souza, Rita Auxiliadora Botelho de; Brasil, Leila Melo; Araújo, Juliana Milani; Ferreira, Luíz Carlos Lima

doi:10.1590/s0037-86822004000100019

Cited by 5 publications

(3 citation statements)

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“…Hepatitis C and E accounted for only 1 case each and Epstein‐Barr virus only 4 cases of more than 1000 cases 80, 81. Other previously unidentified viruses have been suspected of causing indeterminate ALF 7, 82. However, searches for viral agents using sera from indeterminate patients found no cases of parvovirus B19, hepatitis E or SEN virus 83, 84.…”

Section: Other Causes Of Alfmentioning

confidence: 99%

Acute liver failure: Summary of a workshop

et al. 2007

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Acute liver failure (ALF) is a rare but challenging clinical syndrome with multiple causes; a specific etiology cannot be identified in 15% of adult and 50% of pediatric cases. The course of ALF is variable and the mortality rate is high. Liver transplantation is the only therapy of proven benefit, but the rapidity of progression and the variable course of ALF limit its use. Currently in the United States, spontaneous survival occurs in approximately 45%, liver transplantation in 25%, and death without transplantation in 30% of adults with ALF. Higher rates of spontaneous recovery (56%) and transplantation (31%) with lower rates of death (13%) occur in children. The outcome of ALF varies by etiology, favorable prognoses being found with acetaminophen overdose, hepatitis A, and ischemia (Ϸ60% spontaneous survival), and poor prognoses with drug-induced ALF, hepatitis B, and indeterminate cases (Ϸ25% spontaneous survival). Excellent intensive care is critical in management of patients with ALF. Nonspecific therapies are of unproven benefit. Future possible therapeutic approaches include N-acetylcysteine, hypothermia, liver assist devices, and hepatocyte transplantation. Advances in stem cell research may allow provision of cells for bioartificial liver support. ALF presents many challenging opportunities in both clinical and basic research. A cute liver failure (ALF) is a dramatic but rare clinical syndrome marked by the sudden loss of hepatic function in a person with no prior history of liver disease. The causes of ALF include viral hepatitis, drug-induced and toxin-induced liver disease, metabolic errors, ischemia, and miscellaneous rare causes. Currently, there are no specific therapies of proven benefit except for emergency liver transplantation. The many challenges in understanding and management of ALF led to the organization of a 2-day research workshop held on December 4-5, 2006 in Bethesda, Maryland, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) with support from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) and the Office of Rare Diseases of the National Institutes of Health (NIH). This manuscript summarizes the presentations at that meeting and the recommendations arising therefrom. Overview of ALF Epidemiology and Etiology in AdultsThe sudden loss of hepatic function in a person without preexisting liver disease defines ALF. 1,2 The most reliable signs of severe acute liver injury are the presence of coagulopathy (international normalized ratio [INR] Ն 1.5) and any degree of hepatic encephalopathy, the length of illness being considered anything Յ 24 weeks. Many patients evolve to coma within 1 week or less. The term "acute liver failure" is preferable to fulminant hepatic failure 1 or acute hepatic necrosis. 2 ALF is rare and represents a syndrome rather than a specific disease, having multiple causes that vary in course and outcome. 1401The rarity of ALF and its unpredictable, severe course make it a challenging entity for prospec...

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Section: Other Causes Of Alfmentioning

confidence: 99%

Acute liver failure: Summary of a workshop

et al. 2007

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“…Porém, em 2004, estudos revelaram a participação efetiva de outros vírus hepatotrópicos nesta entidade 48 .…”

Section: Vírus Da Hepatite D (Mariounclassified

Histórico das hepatites virais

Fonseca¹

2010

Rev. Soc. Bras. Med. Trop.

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RESUMOIntrodução: A história das hepatites virais remonta milhares de anos e é fascinante. Quando o ser humano sofreu pela primeira vez a invasão do seu organismo por tais agentes, iniciou-se um ciclo natural e repetitivo capaz de infectar bilhões de seres humanos, dizimar e sequelar milhares de vida. Métodos: Este artigo rever informações científicas disponíveis sobre o histórico das hepatites virais. Todas as informações foram obtidas através de extensa revisão bibliográfica, compreendendo artigos originais e de revisão e consultas na rede internet. Resultados: Existem relatos de surtos de icterícia epidêmica na China há mais de 5.000 anos e na Babilônia, há mais de 2.500 anos. A história catastrófica das grandes epidemias ou pandemias ictéricas são conhecidas e geralmente estão associadas às grandes guerras. Na guerra da Secessão Americana, 40 mil casos ocorreram entre militares da União. Em 1885, um surto de icterícia catarral acometeu 191 trabalhadores do estaleiro de Bremen (Alemanha) após vacinação contra varíola. Em 1942, 28.585 soldados contraíram hepatite após inoculação da vacina contra a febre amarela. O número de casos de hepatite durante a Segunda Grande Guerra foi estimado em 16 milhões. Somente no século XX, foram identificados os principais agentes causadores das hepatites virais. O vírus da hepatite B foi o primeiro a ser descoberto. Conclusões: Neste artigo, a revisão da história das grandes epidemias ocasionadas pelos vírus das hepatites e a descoberta desses agentes revelam singulares peculiaridades, citando como exemplo, a descoberta acidental ou por acaso dos vírus da hepatite B e D.

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“…In the United States, an estimated 1,000 patients/yr with FHF die while waiting for a liver transplant (10). Although ELT remains the main therapy of FHF, it requires enormous technical and financial resources that cannot be employed in a significant number of countries where FHF is endemic (11)(12)(13)(14)(15).…”

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confidence: 99%