Etiopathogenesis of acute hepatic failure: Eastern versus Western countries

Sk, Acharya; Batra, Yogesh; Hazari, Siddarth; Choudhury,; Panda, Sucheta; Dattagupta, S

doi:10.1046/j.1440-1746.17.s3.12.x

Cited by 60 publications

(36 citation statements)

References 61 publications

(175 reference statements)

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“…ALF etiologies vary worldwide: while in Eastern developing countries, viruses (mainly hepatitis A, B, or E) may account for up to 95% of all ALF cases, the Western developed countries have reported more heterogeneous causes of ALF [3, 4]. In the UK and North America, paracetamol overdosage has been the leading cause of ALF [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Acute Liver Failure from a Regional Liver Transplant Center in Portugal

Simões

Santos

Vicente

et al. 2018

GE Port J Gastroenterol

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Background and Aims: Acute liver failure (ALF) is a rare disease with potentially high mortality rates. We aimed to study the recent epidemiology of ALF in one of the Portuguese liver transplant (LT) regions. Methods: We assessed a retrospective cohort including 34 consecutive patients with ALF admitted to the intensive care unit (ICU) of Curry Cabral Hospital (Lisbon, Portugal) between October 2013 and December 2016. Results: The median age (IQR) was 49 (31–67) years, and 21 (62%) of the cohort were female. Non-paracetamol etiologies were found in 29 patients (85%). On ICU admission, grade 3–4 hepatic encephalopathy developed in 10 patients (29%); invasive mechanical ventilation, vasopressors, and renal replacement therapy were required for 8 (24%), 7 (21%), and 5 (15%) of the patients, respectively; the King’s College criteria (KCC) were fulfilled by 16 patients (47%). Of the 15 (44%) nontransplanted patients, 11 (73%) died during their hospital stay. Of the 19 (56%) transplanted patients, 4 (21%) died during their hospital stay. KCC were not associated with hospital mortality (p = 0.97), but they were significantly associated with LT (p = 0.008). Conclusions: In a Portuguese cohort of patients with ALF, non-paracetamol etiologies were predominant. Hospital mortality was much lower amongst transplanted patients.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Acute Liver Failure from a Regional Liver Transplant Center in Portugal

Simões

Santos

Vicente

et al. 2018

GE Port J Gastroenterol

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“…[49] So the quality of life is far better in survivors who have not undergone liver transplantation. Most of the data on FHF have been reported from USA,[10] UK,[11] the Far East,[212] and France. [13] The etiology and predictors of outcome in Western populations differ from that in developing countries.…”

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confidence: 99%

Natural course of fulminant hepatic failure: The scenario in Bangladesh and the differences from the west

Alam

Azam

Mustafa

et al. 2009

Saudi J Gastroenterol

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Background/Aim:Fulminant hepatic failure (FHF) is a devastating complication of acute viral hepatitis, leading to death in most cases. The etiology and predictors of outcome differ according to the geographical region. This study was conducted with the aim of evaluating the etiology, complications, and outcome of FHF in Bangladesh.Patients and Methods:In this prospective study, we included 67 consecutive cases of FHF presenting to the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, between November 2003 and May 2008. Thirty-nine of the patients were male and 28 were female. Data was analyzed using SPSS, version 13.0.Results:The mean age of the subjects was 31.9 ± 11.7 years. Hepatitis E virus (HEV) was the commonest etiological factor for FHF (50 cases, 74.6%); of the 50 cases with HEV infection, 43 (64.2%) were not coinfected with any other virus, four cases were Hepatitis B virus (HBV) carriers, and three had coinfection with hepatitis A virus (HAV). HBV was the cause of FHF in nine (13.4%) patients. HCV, paracetamol, and alcohol were not responsible for any of the cases. Most of the patients (57 patients, 85%) developed FHF within 2 weeks of the onset of jaundice. Of the 67 patients, 49 (73.1%) died. Cerebral edema was the single most common cause of death (48 patients, 71.6%). Other complications were renal failure (23 patients, 34.3%), sepsis (15 patients, 22.4%), electrolyte imbalance (12 patients 17.9%), and bleeding tendency (7 patients, 10.4%). Occurrence of cerebral edema, longer prothrombin time, higher grade of encephalopathy, and longer jaundice-to-encephalopathy interval had significant negative influence on outcome.Conclusions:The etiology of FHF in Bangladesh is different from that in the West. Prolongation of prothrombin time and occurrence of cerebral edema are predictors of the worst prognosis.

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“…Patients who developed encephalopathy after the onset of icterus were considered to have acute hepatic failure [6] .…”

Section: Methodsmentioning

confidence: 99%

Etiological Study of Acute Hepatocellular Jaundice With Special Reference to Acute Viral Hepatitis in North East India

Loitongbam¹,

Das²,

Kar³

et al. 2014

jemds

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BACKGROUND: Acute viral hepatitis (AVH) due to Hepatitis-A virus infection (HAV) andHepatitis E virus infection (HEV) are considered as a major public health problem and is an important cause of morbidity and mortality both in developing and developed countries. Acute hepatocellular jaundice can be caused by viral hepatitis, drugs, toxins, other infections and alcohol. AIM: To determine the etiology of acute hepatocellular jaundice in a tertiary care hospital of North East India and to study the biochemical changes in cases of acute hepatocellular jaundice of different etiologies. SUBJECTS AND METHODS:The study involved 121 patients of hepatocellular jaundice admitted in different medicine wards of Assam Medical College and Hospital over a period of one year. Detailed clinical and biochemical investigations were carried out. Samples were tested for routine hemogram, liver function tests and serology for different hepatotropic viruses. RESULTS: Of all cases, 82 were of viral and 39 cases were of non-viral origin. Overall, maximum cases of acute hepatocellular jaundice occurred in third and fourth decade of life. HAV (39.02%) was most common cause, followed by HEV (18.29%), HBV (4.88%) and hepatitis C (1.2%). Among non-viral cases, 20 (51.28%) were due to Falciparum malaria, 7 (17.9%) due to drugs, 6 due to alcohol, 4 due to leptospira and 2 cases were due to mushroom poisoning. Serum bilirubin, ALT, AST, alkaline phosphatase (ALP) and PT were more altered in AVH group compared to non-viral group. CONCLUSION: Hepatitis A remains the commonest cause of acute hepatocellular jaundice and there is also an increasing trend for higher age group of hepatitis A infection as opposed to malaria in non-viral acute hepatitis. Biochemical changes were more marked in AVH.

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Etiopathogenesis of acute hepatic failure: Eastern versus Western countries

Cited by 60 publications

References 61 publications

Epidemiology of Acute Liver Failure from a Regional Liver Transplant Center in Portugal

Epidemiology of Acute Liver Failure from a Regional Liver Transplant Center in Portugal

Natural course of fulminant hepatic failure: The scenario in Bangladesh and the differences from the west

Etiological Study of Acute Hepatocellular Jaundice With Special Reference to Acute Viral Hepatitis in North East India

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