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August 2013 Vol. 2 Issue
8
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Morad WS
Allam AA
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Global Advanced Research Journal
of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
August 2013 Vol. 2(8), pp.
184-189
Copyright © 2013 Global Advanced
Research Journals
Full Length Research Paper
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Factors predicting
fulminant course of acute Hepatitis A with special
emphasis on predictors of mortality in Egyptian
children
Wesam Saber Morad1*, Yasser Rashed2,
and Alif A. Allam2
1Community
Medicine and Public Health, National Liver
Institute, Menoufiya University.
2Pediatric
Hepatology, National Liver Institute, Menoufiya
University.
*Corresponding Author E-mail:
wesammorad@yahoo.com; Mobile: +201009066238
Accepted 20 August, 2013
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Abstract |
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Hepatitis A virus (HAV), a non
enveloped RNA virus, is particularly resistant and
contagious. The infection is spread chiefly by fecal-
oral transmission and is a public health problem
throughout the world. The main complication of HAV
infection is fulminant hepatitis (FH). This study
was done on 80 children, 50 with acute hepatitis A
virus and 30 developed fulminant hepatic failure, 52
males and 28 females. In fulminant group 12
recovered with normal liver function, but 18 were
died. Children recovered from fulminant liver
failure had encephalopathy grade 1 or 2. The study
showed statistically significant differences between
acute hepatitis A virus and low socioeconomic level
and bad hygiene (P < 0.004), children received anti
convulsive therapy P < 0.009 and also with diabetic
children P < 0.004. Total bilirubin > 9.56, Direct
bilirubin > 5.11, ALT > 1365.7, AST > 1635.78,
Prothrombin time prolonged more than 25.87 seconds
are indices for increasing the risk for developing
fulminant hepatic failure in children with acute HAV(
P <0.000001, P <0.00001, P < 0.00001, P < 0.0001, P
<0.00001 respectively). Mortallity rates was
statistically significant related to prolonged
prothrombin time, decreased ALT and AST, elevation
of serum bilirubin and blood urea and serum
creatinine and also with high grade of coma (grade 3
and 4). This study emphasize that early
prediction of FHF can be predicted by simple tests
and appropriate medical treatment could block
further liver destruction and prevent development of
FHF.
Keywords:
Hepatitis A virus; fulminant hepatitis; fecal- oral
transmission;
Risk factors; low socioeconomic level.
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