Abstract

ABSTRACT:
BACKGROUND:
Pediatric acute liver failure (PALF) is a complex, rapidly progressive clinical syndrome that is
the final common pathway for many disparate conditions, some known and others yet to be
identified. Acute liver failure was first defined by Trey and Davidson as a potentially reversible
condition caused by severe liver damage accompanied by encephalopathy onset and in the absence of preexisting liver disease.
OBJECTIVE:
To assess the etiology, prognosis and outcome of FHF in a sample of Iraqi child patients
PATIENTS AND METHODS:
A prospective study was done on (50) patients diagnosed with acute hepatic failure admitted to
the Gastroenterology and Hepatology unit in Children Welfare Teaching Hospital during the period
from January 2015 to the December 2015. The patients referred to our center from all over Iraq,
Detailed history, clinical examination, routine biochemical parameters, and relevant tests were
carried out to all patients. Patients enrolled in this study with the age less than 16 years old with
the exception of neonate (< 1 month). The acute hepatic failure was diagnosed with prolonged PT,
PTT, elevated liver function test and the disturbance of level of consciousness.
RESULTS:
Hepatitis A was found to be the commonest cause of encephalopathy and was diagnosed in 18/50
(36.0%) of cases, 56% of cases presented with GIT bleeding, 32% of them presented with melena.
The worst outcome (100% mortality) was associated with sepsis, CMV infection, and biliary atresia,
and best outcome was associated with Wilson disease (20% mortality). The poor prognosis was
found in grade 3 and 4 of encephalopathy and 68% of child died.
CONCLUSION:
Hepatitis A is the most common cause of the FHF with high mortality rate. Bad prognosis was found
in grade 3 and 4 of encephalopathy, with GI bleeding, longer duration of illness before onset of
encephalopathy.