Fulminant Hepatitis

Overview

Fulminant Hepatitis is a complication of acute viral hepatitis that manifests as rapid functional decompensation of the liver.

Etiology and Pathogenesis

Fulminant Hepatitis occurs in the context of acute viral hepatitis. It is rare during hepatitis A or C virus infection. Most cases are due to Hepatitis B Virus infection with or without Hepatitis D Virus. It is most likely the result of a massive, overly-exuberant immune response to the presence of virus, resulting in rapid inflammatory damage to the liver.

Clinical Consequences

Overview

Fulminant Hepatitis is characterized by certain signs of hepatic failure that can manifest rapidly and thus does not include those that require chronic timescales to develop.

Symptomology

Hepatic Encephalopathy: Characterized by altered mental status, confusion, somnolence, or coma
Brain Edema: May occur, possibly resulting in cerebral herniation
Hepatorenal Syndrome: Which may result in acute renal failure
Generalized Edema: Due to rapid hypoalbuminemia
Prolonged Prothrombin Time (PT): Due to reduced synthesis of coagulation proteins
Jaundice: Due to hyperbilirubinemia
ARDS may result

Prognosis

Fulminant Hepatitis has a high degree of mortality and is rapidly fatal.