Halothane hepatitis in a prospective study of postoperative complications

Zaric, Dusanka; Larsen, Svend; Jacobsen, Erik; Olesen, Knud H.; Ranek, L

doi:10.1111/j.1399-6576.1986.tb02469.x

Cited by 10 publications

(3 citation statements)

References 21 publications

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“…His halothane hepatitis came to notice only because he developed a more obvious and prolonged illness after his ninth exposure, and therefore he was kept in hospital. It is likely that cases with milder involvement such as that following his eighth exposure far outnumber full-blown cases in children, as has been shown by prospective studies in adults (14). Only one small prospective study has been reported in children, with up to 10.6% patients having elevation of serum transaminases after multiple halothane exposures (15).…”

Section: Discussionmentioning

confidence: 98%

Halothane Hepatitis in Children

Hassall,

Israel,

Gunasekaran

et al. 1990

J. pediatr. gastroenterol. nutr.

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Halothane hepatitis is now a well‐recognized distinct entity in adults, but there prevails an often‐taught “axiom” that halothane hepatitis “does not occur” in children. We describe 2 children who developed cholestatic hepatitis following halothane anesthesia. The first patient had no antecedent liver disease, and presented with anorexia, abdominal pain and delayed onset of jaundice after multiple halothane exposures. Halothane‐specific antibodies were positive, and liver tests resolved completely. The second patient had antecedent liver disease and presented with delayed onset of unexplained high fevers for 10 days following a single halothane exposure. Gradually increasing cholestasis ensued in the absence of other causes of liver disease. Halothane antibodies were negative. These cases illustrate different clinical presentations of halothane hepatitis, such as delayed onset of jaundice or fever following halothane exposure. The difficulties in making a definitive diagnosis and the need to exclude other causes of liver disease are detailed. Risk factors and other presentations are discussed. While halothane hepatitis appears to be an uncommon entity in children, it does occur, and may present with manifestations less than fulminant hepatic failure. A high index of suspicion and a detailed history of the time sequence of events are necessary as the diagnosis is primarily clinical. Halothane‐specific antibodies are helpful if positive. In any child developing unexplained jaundice or high fevers following halothane anesthesia, further exposures should be avoided and halothane‐specific antibodies obtained.

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Section: Discussionmentioning

confidence: 98%

Halothane Hepatitis in Children

Hassall,

Israel,

Gunasekaran

et al. 1990

J. pediatr. gastroenterol. nutr.

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show abstract

“…Die früher vertretene Ansicht, daß Wiederholungsnarkosen mit Halothan unproblematisch seien, wenn zwischen den Anwendungen mindestens drei Monate vergangen seien, kann heute nicht mehr aufrechterhalten werden (6). Auch nach Intervallen von mehreren Jahren wurden schwere Leberschäden beschrieben (12).…”

Section: Prädisponierende Faktorenunclassified

“…Zaric u.Mtarb. fanden im Rahmen einer prospektiven Studie klinisch signifikante Leberschäden bei 4 von 1166 für kleinere orthopädische Eingriffe mit H a l o than anästhesierten Patienten(12). Es handelte sich in diesen 4 Fällen um adipöse Patientinnen, von denen drei bereits früher Halothannarkosen gehabt hatten.…”

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