Fulminant Hepatitis Can Quickly Be Life Threatening

Bumisuka.com – Fulminant Hepatitis Can Quickly Be Life Threatening. Fulminant hepatitis is a condition in which the liver or liver begins to fail very quickly within days or weeks, depending on the cause. Sudden liver failure can occur in people who previously had stable liver disease or who have never had liver problems.

Fulminant hepatitis is also referred to as fulminant liver failure or acute liver failure. This condition quickly becomes life-threatening. Seek immediate medical attention if you or someone close to you shows signs and symptoms.

1. Cause

There are many causes of hepatitis. Not all are related to fulminant hepatitis, but there is a lot of overlap.

According to a 2008 report in the journal Liver Transplantation, the most common causes of fulminant hepatitis are:

• Overdose, especially acetaminophen.
• Viral hepatitis, especially hepatitis B.

Generally, viruses are the most common cause of fulminant hepatitis, whereas acetaminophen overdose is more common in the United States and United Kingdom. Overdose can be intentional or unintentional.

In general, the causes of fulminant hepatitis can be divided into viral, toxic, and other, less common, causes.

Virus

The most common viruses associated with fulminant hepatitis are:

• hepatitis A virus
• Hepatitis B virus, the main cause of fulminant hepatitis.
• Hepatitis E virus
• Varicella-zoster virus.
• Herpes simplex virus.
• Parvovirus B19.
• Epstein-Barr virus.

Generally, when diagnosing fulminant hepatitis, doctors will consider hepatitis A, B, or E as a possible cause. Fulminant hepatitis is rarely associated with the other viruses mentioned above.

Fulminant hepatitis can develop from acute hepatitis B infection, but it can also occur in people who have reactivation of chronic hepatitis B. Fulminant hepatitis from hepatitis B infection causes death or liver transplantation in up to 80 percent of the time.

Poison or medicine

The poisons or drugs most associated with fulminant hepatitis can include:

• Acetaminophen overdose is the most common cause of fulminant hepatitis.
• Some mushrooms are poisonous, for example Amanita phalloides.
• Several types of antibiotics.
• Ecstasy.
• Antituberculosis antibiotics.
• Non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen.
• Overdose of iron supplements.
• Some Chinese herbs.
• Chlorpromazine, a drug for psychotic disorders.
• Ondansetron, an anti-nausea drug.
• Stavudine, a drug for HIV.

Other causes

Other factors known to cause fulminant hepatitis include:

• Wilson’s disease, a congenital disorder in which copper accumulates in the liver.
• Metastatic cancer, leukemia, or lymphoma.
• Autoimmune hepatitis.
• Heatstrokes.
• Budd-Chiari syndrome, namely blockage of blood vessels in the liver.
• Ischemic liver failure due to severe cardiovascular disease or sepsis.
• HELLP syndrome during pregnancy.
• Fatty liver disease.

2. Symptoms

Initially, symptoms of fulminant hepatitis may include:

• Feeling unwell.
• Fatigue.
• Nauseous.
• Discomfort in the stomach or stomach pain.

If the condition worsens, the following symptoms can be felt:

• Yellowing of the skin or eyeballs (jaundice).
• Confusion.
• Sleepy.
• Changes in behavior or personality.
• Easy bruising or bleeding.
• Abdominal swelling.

3. Diagnosis

Reported by WebMD, the doctor will ask about your medical history, history of drug use, and whether you have been exposed to poison. The doctor will also check for hepatitis symptoms and mental alertness tests.

To help diagnose and find the cause of fulminant hepatitis, your doctor may order:

• Blood and urine tests: The results will show how well the liver is working. The doctor will also test how long it takes for the blood to clot. In fulminant hepatitis, blood does not help as quickly as it should.
• Liver imaging: Imaging tests allow your doctor to check for liver damage, blood vessel problems, tumors, or other problems. This can be done with an ultrasound, MRI, or CT scan.
• Liver biopsy: The doctor may take a small amount of liver tissue for examination in a laboratory.

4. Treatment

If you have fulminant hepatitis, you will most likely be admitted to the intensive care unit. Treatment for sudden liver failure depends on the cause.

• Antidotum: This is a type of medicine used to counteract the effects of poison. If your liver suddenly fails from an overdose of acetaminophen, your doctor may give you an antidote of N-acetylcysteine to stop its effects. This medication may also help treat other causes of acute liver failure. Other antidotes can help reverse the effects of mushroom poisoning and help reduce liver damage.
• Medications for hepatitis: Doctors use antivirals to treat some forms of viral hepatitis. For example, if hepatitis B is the cause of acute liver failure, antivirals can fight the virus. Other antivirals may be helpful if the herpes simplex virus is causing fulminant hepatitis. Steroids may be given if autoimmune hepatitis is the cause.
• Liver transplant: If other treatments don’t work, you may need a transplant. During the procedure, surgeons remove the damaged liver and replace it with a healthy liver from a donor. Experts are researching new treatments that might reduce or slow down the need for liver transplants.

The doctor will also treat the symptoms and side effects you have. Treatment may include:

• Medicines to relieve pressure on the brain: One of the serious side effects of acute liver failure is swelling in the brain. The extra fluid causes pressure to build up which can cause brain damage. Some medications can help relieve swelling.
• Tests to check for infection: Fulminant hepatitis makes you more likely to have an infection in your blood or urinary tract, for example. Blood or urine tests can find an infection and a doctor can treat it.
• Medicines to prevent bleeding: The liver produces chemicals that help blood clot. When the liver begins to fail, it makes its production decrease. As a result, the chance of experiencing severe bleeding in the body is higher. If you lose a lot of blood, chances are you’ll get a blood transfusion.

5. Prevention

In some cases, fulminant hepatitis can be prevented. Remember, the two main causes are acetaminophen overdose and viral hepatitis. So, you can minimize your risk of fulminant hepatitis, including:

• Use acetaminophen wisely. Check the drug packaging for dosage recommendations and don’t use more than recommended.
• Avoid contact with other people’s blood and fluids. This can lower your risk of being infected with viral hepatitis. Avoid drinking tap water in areas where the cleanliness of the water is questionable. In addition, get vaccines to prevent hepatitis A and B.

Being diagnosed with fulminant hepatitis and possibly needing a liver transplant can be daunting. However, there are steps you can take to prevent the possibility of developing fulminant hepatitis. Consult with your doctor about the right dosage of drugs for pain relievers and get available hepatitis vaccines.