Risk factors for Fulminant Hepatic Failure and their relation with outcome in children

Objective: To identify the risk factors for fulminant hepatic failure (FHF) and their relation with the outcome in children. Methods: Descriptive case study was conducted at National Institute Of Child Health. Fifty patients having clinical and biochemical markers suggestive of FHF were included in this study and data was extracted from files, retrospectively. Their outcome was noted as expiry or recovery during hospital stay. Results: The most common etiology found was viral in origin present in thirty-seven (74%) cases. Out of them twenty-eight (56%) had HAV and nine (18%) had HBV. Thirteen (26%) patients were negative for acute serology of hepatrophic viruses, out of them four (8%) had Wilson s disease and one (2%) had autoimmune hepatitis. Etiology could not be established in eight (16%) cases. Thirty (60%) patients expired and twenty (40%) patients recovered. Conclusion: FHF is not uncommon in children. Hepatitis A is most common cause in paediatric age group. Age less than 4 years, higher degree of encephalopathy, INR 4, higher serum bilirubin with lower SGPT has poor outcome and mortality is high without liver transplantation.