Abstract
This is prospective cross-sectional study on 37 patients presenting to different hospitals in Khartoum state, Sudan, sought to determine the etiology, clinical course, and predictors of mortality in patients presenting with fulminant hepatic failure (FHF). Patients were subclassified into hyperacute, acute, and subacute FHF; all sera were tested for hepatitis A, B, C, and E; negative samples were tested for antinuclear antibodies and anti-smooth muscle antibodies. The commonest etiologic factors included seronegative hepatitis (38%), hepatitis B virus (22%), severe Plasmodium falciparum malaria (8%), autoimmune hepatitis (8%), hepatitis E virus (5%), anti-tuberculous drugs (5%), and lymphomatous infiltration of the liver (5%). The mortality rate was high at 84%. Poor prognostic factors included presentation with grade III/IV encephalopathy, evidence of bacterial infection, and a prolonged prothrombin time of >25 seconds over the controls.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
O’Grady JG, Alexander GJM, Hayllar KM, Williams R (1989) Early indicators of prognosis in Fulminant hepatic failure. Gastroenterology 97:439–445
Acharya SK, Dasarthy S, Kumer TI, Sushma S, Uma Prasana KS, Tandon A, et al (1996) Fulminant hepatitis in a tropical population: Clinical course, cause and early predictors of outcome. Hepatology 23:1448–1455
Ostapowicz G, Fontana RJ, Schiodt FV, Larson A, Davern TJ, Han SHB, et al (2002) Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 137:947–954
Takahashi Y, Shimuzi M (1991) Aetiology and prognosis of fulminant viral hepatitis in Japan: a multicentre study. The Study Group of Fulminant Hepatitis. J Gastroenterol Hepatol 6:159–164
O’Grady JG (2005) Acute liver failure. Postgrad Med J 81:148–154
O’Grady JG, Schalm S, Williams R (1993) Acute liver failure: redefining the syndromes. Lancet 342:373–375
Johnson PJ, McFarlane IG (1993) Meeting report: International Autoimmune Hepatitis Group. Hepatology 18:998–1005
Hyams KC, al-Arabi MA, al-Tagani AA, Messiter JF, al-Gaali AA, George JF (1989) Epidemiology of hepatitis B in the Gezira region of Sudan. Am J Trop Med Hyg 40:200–206
Suliman SM, Fadlalla M, Nasr ME, Beliela MH, Fesseha S, Babiker M, et al (1995) Poisoning with hair-dye containing paraphenylene diamine; ten years experience. Saudi J Kidney Dis Transplant 6:286–289
World Health Organization (1988) Memoranda: progress in the control of viral hepatitis: memorandum from a WHO meeting. Bull WHO 66:443–455
Tatsuya I, Feadil SS, Sliman I, Ali AK, Higashi T, Tsuji T (1989) Hepatitis B virus markers in patients with schistosomiasis, liver cirrhosis and hepatocellular carcinoma in Khartoum, Sudan. Acta Med Okayama 43:241–244
Joshi YK, Tandon BN, Acharya SK, Babu S, Tandon M (1986) Acute hepatic failure due to Plasmodium falciparum liver injury. Liver 6:357–360
Kochar DK, Agarwal P, Kochar SK, Jain R, Rawat N, Pokharna RK, et al (2003) Hepatocyte dysfunction and hepatic encephalopathy in Plasmodium falciparum malaria. QJM 96:505–512
Acknowledgments
The authors thank Professor O.Z. Baraka, Professor S.S. Fedail, Professor M. Muktar, Dr. Sahar, and Dr. Misk Alyaman for their immense support throughout the study period.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mudawi, H.M.Y., Yousif, B.A. Fulminant Hepatic Failure in an African Setting: Etiology, Clinical Course, and Predictors of Mortality. Dig Dis Sci 52, 3266–3269 (2007). https://doi.org/10.1007/s10620-006-9730-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-006-9730-z