What is fulminant hepatitis

In the structure of morbidity, the pathology of the gastrointestinal tract occupies one of the leading places. The number of reported cases increases after 14 years. Conditions significantly reduce the quality of life. According to statistics from the World Health Organization, in recent years, liver damage has increased among all gastrointestinal diseases.

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How is it dangerous for fulminant hepatitis?

Fulminant hepatitis is a rare and dangerous type of liver damage. Necrosis of hepatocytes occurs due to processes at the pathomorphological and biochemical levels. Changes in the liver are extremely acute. The disease is dangerous, first of all, with a high mortality rate, in contrast to other types of pathology.

Most often, fulminant hepatitis develops in carriers of hepatotropic viruses. Other viruses and drugs, especially those with tropism, can also be the cause. Some congenital and acquired diseases pose a threat – osteohepatitis. Thus, it is a polyetiological disease.

In children, fulminant hepatitis has its own characteristic features: a very rapid development from several days to several hours, so timely provision of qualified medical care is extremely important. Unfortunately, a poor prognosis in infants. Most often these are children born to mothers who are carriers of the virus. Infection occurs already in utero. Alternatively, the baby can be infected during a blood transfusion. Most often these are babies with hemolytic disease of the newborn. But even such complex cases lend themselves to therapy.

Stage of the disease

The fulminant form of hepatitis has three stages. The first is the period of harbingers. The second is the precom. The third one corresponds to coma I and coma II. Acute fulminant hepatitis primarily causes damage to the liver and central nervous system.

Symptoms and Diagnosis

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Fulminant viral hepatitis is characterized by the development of liver failure, an acute onset with a sharp increase in temperature, weakness, lethargy, drowsiness, alternating with bouts of motor excitement, anxiety. In children, psychomotor agitation is noted.

Vomiting occurs, repeating the entire period of the disease. The blood coagulation system is affected, which causes internal bleeding and vomiting takes on a characteristic color. There is a hemorrhagic syndrome – hemorrhagic rash on the skin and mucous membranes, the development of uterine bleeding. Hepatic odor emanates from the patient. Fever is often kept at the last stage of the process.

Rapidly growing jaundice. On examination, the doctor may notice a sharp decrease in organ size. General changes in the body are observed – tachycardia, a drop in blood pressure, a daily decrease in excreted urine, a violation of the rhythm of breathing. If timely assistance is not provided, a life-threatening coma develops.

Clinical signs of fulminant hepatitis are confirmed by tests. Additional research is being conducted. The patient is prescribed a biochemical blood test, in particular, liver function tests. Increased bilirubin, which is rapidly increasing. AlAt, AsAt are elevated and indicate necrosis of hepatocytes – a structural unit.

But with the further development of pathology, cytolytic enzymes decrease. The lipid profile shows a decrease in triglycerides, ether-bound and free cholesterol. Changes in the general laboratory analysis are observed – anemia, mainly of microspherocytic origin, leukocytosis with a shift of the neutrophilic formula to the left, lymphopenia, increased ESR.

Treatment

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Treatment of fulminant fulminant hepatitis is carried out in the box of the infectious diseases department, hepatological centers. In special cases – resuscitation. The doctor prescribes bed rest, the duration of which is selected individually.

Diet table number 5 with restriction of protein and fat intake. Food is fractional, in small portions. In the event of coma, parenteral and enteral nutrition is provided, mainly glucose.

The leading method of treatment is detoxification and symptomatic therapy. The main rule is not to harm.

It is better to use Reamberin as a detoxification method. The product is made on the basis of succinic acid. Additionally, this drug acts as a diuretic and memranostabilizer.

It is permissible to use Reopolyglkin, glucose-salt solutions, plasma substitutes. The doctor calculates the dose individually, taking into account the body weight and the severity of the condition. Additionally, high cleansing enemas are performed. Doctors did not come to a consensus on the use of glucocorticosteroids for this pathology.

In some cases, this tactic of patient management is very effective. In the complex, hepatoprotectors are used, which allow the affected organ to recover. But the leading method remains detoxification therapy. The procedures are carried out until the symptoms disappear completely.

Medicine does not stand still and new technologies make it possible to help patients whose body has not responded to drug therapy. Liver transplantation is a highly effective method in the fight against such pathological conditions. Its use gives a 100% guarantee of recovery.

The disadvantage of the method is the difficulty in finding a donor, which is not always possible soon, the availability of medical centers conducting such operations and a long rehabilitation period is not always.

Recently, xenografts are gaining popularity. Under laboratory conditions, an artificial hepar is created from pig hepatocytes. This technique allows you to restore the affected organ. When raising the issue of transplantation, a person is given the opportunity to gain time before finding a donor, which has helped to increase the survival rate and quality of life.

Prevention

Fulminant hepatitis can be prevented. It is better to prevent a nuisance than to cure it later. There are primary and secondary prevention. The primary includes – the annual passage of preventive examinations, limiting the consumption of alcohol, medicines, the use of mechanical protective equipment during sexual intercourse.

Passage of all stages of research of fluids for transfusion. Secondary – registration for dispensary registration of persons who have suffered a disease, rehabilitation in local sanatoriums, balneological resorts. Lifelong diet according to Pevzner table number 5, maintaining a healthy lifestyle.

If you have been diagnosed, this is not a sentence. Early detection of the disease increases the chances of recovery. Don’t delay seeing your doctor when certain signs appear. Take care of your health.

VIDEO

Fulminant hepatitis: features, diagnosis, treatment.

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Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

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