Early treatment with N-acetylcysteine in <br /> children with acute liver failure secondary to hepatitis A<br />
Journal Title: Annals of Hepatology - Year 2009, Vol 8, Issue 4
Abstract
Introduction. Hepatitis A virus can evolve to acute liver failure with a fatal outcome if it is not reversed. Objective. We describe the clinical course of 12 children who presented with hepatitis A acute liver failure and received treatment with oral N-acetylcysteine (NAC). Materials and methods. Of the seventy-two patients with viral hepatitis A, 12 patients who had acute hepatic failure were included. The variables evaluated were age, sex, duration of clinical features prior to hospitalization, signs and symptoms, laboratory parameters [alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), partial thromboplastin time (PTT), internal normalization ratio and ammonia], treatment (oral NAC 100 mg/kg/day, lactulose, neomycin and general measures) and clinical course during hospitalization. Results. Six males and six females were included. School-aged and adolescent children predominated. All presented with jaundice, nausea, vomiting and hepatomegaly. Two had stage 2 neurological signs as per the West–Haven scale. All had altered laboratory parameters. All received NAC, six patients for a week and the remaining six for 9-36 days. Treatment was not ceased until patients showed clinical and laboratory improvement. All data were analyzed using both student’s t test and Wilcoxon signed rank with alpha = 0.05, the ALT with P = 0.0003 and 0.005, AST with P = 0.0001 and 0.0005, PT with P = 0.0237 and 0.0005, PTT with P = 0.0515 and 0.0039, ammonia with P = 0.0197 and 0.0015 and direct bilirubin with P = 0.0190 and 0.068. There was good tolerance to medications and a satisfactory clinical course. Discussion. The use of oral NAC appears to be an effective therapeutic alternative for hepatitis A-induced liver failure if it is offered appropriately. It can modify the clinical course to a favorable one and prevent the fatal outcome of hepatic encephalopathy.
Authors and Affiliations
Norberto Sotelo, Maria de los Àngeles Durazo , Alejandro Gonzalez, Nagasharmila Dhanakotti
Keywords
Related Articles
- EP ID EP77891
- DOI -
- Views 139
- Downloads 0
Frequency of hepatitis C virus infection in a single institution in Mexico with a focus on birth-cohort population
Background and rationale for the study. The generation of people born before 1965 is a high-risk group for developing chronic hepatitis C virus (HCV) infection. Aim. To report the experience on single institution of HCV...
Hepatotoxicity associated with statins
Severe aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome in a patient with non-A-E hepatitis virus infection
Intestinal nuclear bile acid receptor FXR and cholestasis
Hepatic Echinococcosis with Thoracic Involvement. Clinical Characteristics of a Prospective Series of Cases
Abstract Introduction. Thoracic involvement (TIHE) is one of the evolutionary complications of hepatic echinococcosis (HE). Aim. The aim of this study was to describe the clinical characteristics and postoperative morbid...