fulminant hepatitis-like syndrome
Introduction
Introduction to fulminant hepatitis-like syndrome Fulminant Hepatitis (Like) syndrome, a group of non-viral hepatitis with a fulminant hepatitis-like syndrome. These include acute fatty liver in pregnancy, tetracycline-induced toxic hepatitis and Reye syndrome, but if cured, the liver can return to normal. This group of symptoms showed acute onset, severe nausea, vomiting and bloating, bleeding tendency, disturbance of consciousness and other symptoms. basic knowledge The proportion of illness: 0.008% Susceptible people: mostly primiparas aged 20 to 30 Mode of infection: non-infectious Complications: hypoglycemia pancreatitis
Cause
Cause of fulminant hepatitis-like syndrome
Cause:
Acute fatty liver in pregnancy is mostly primipara 20 to 30 years old, occurring in the third trimester of pregnancy (36 to 40 weeks). Acute fatty liver caused by tetracycline poisoning is caused by taking a large amount of tetracycline antibiotics to cause acute fatty liver. Reye syndrome is also called Encephalopathy Fatty liver syndrome is caused by cerebral edema caused by viruses, poisoning and metabolic disorders, and fat deposition in organs such as liver and kidney.
Prevention
Fulminant hepatitis-like syndrome prevention
Try not to use drugs that are harmful to liver function. Pregnant women between the ages of 20 and 30 should pay attention to protecting the liver and eating less irritating food.
Complication
Complications of fulminant hepatitis-like syndrome Complications hypoglycemia pancreatitis
Death can be caused by acute liver and kidney failure, fatal hypoglycemia, DIC, hemorrhagic pancreatitis and gastrointestinal bleeding.
Symptom
Symptoms of fulminant hepatitis-like syndrome Common symptoms Abdominal pain Jaundice proteinuria Hepatocyte necrosis Hypertension Nausea Liver function impaired Progressive liver reduction Toxic liver damage
First, acute fatty liver during pregnancy
Most patients are primiparas aged 20 to 30 years old. In the third trimester of pregnancy (36 to 40 weeks), facial edema, proteinuria, high blood pressure, followed by upper abdominal pain, nausea, vomiting, and bleeding tendency, jaundice progressive deepening, disturbance of consciousness , blood bilirubin is significantly elevated, urinary bilirubin is negative, blood ALT is not increased, and often has hypoglycemia, the mortality rate is as high as 70% to 80%, the cause of death can be acute liver and kidney failure, fatal Hypoglycemia, DIC, hemorrhagic pancreatitis and gastrointestinal bleeding.
Second, tetracycline poisoning caused by acute fatty liver
Taking a large number of tetracycline antibiotics can cause acute fatty liver, but more pregnant women, pathological manifestations of diffuse steatosis, hepatocyte necrosis and cholestatic, clinical manifestations of sudden fever, jaundice, disturbance of consciousness.
Third, Reye syndrome
Also known as encephalopathy, fatty liver syndrome, refers to cerebral edema caused by viruses, poisoning and metabolic disorders, and fat deposition in liver, kidney and other organs. The clinical manifestations are that children have flu-like precursor symptoms, after 2 to 3 weeks, Sudden onset of frequent vomiting with severe headache, followed by symptoms of impaired liver function and disturbance of consciousness.
Examine
Examination of fulminant hepatitis-like syndrome
1. Liver function test.
2. Serum bilirubin.
3. Urine routine.
4.CT.
5. Hepatitis B two and a half, liver function, HBV-DNA detection, B-ultrasound and so on.
(1) Serum jaundice index and bilirubin quantification:
The liver can make and excrete bile. When the liver cells are damaged, the bile reverses into the bloodstream and causes an increase in serum bilirubin. This test can reflect the presence, extent and nature of the jaundice. There are traces of bilirubin in normal human serum. Normal value: The jaundice index is 4-6 units; the bilirubin level is 17.1 micromoles/liter or less.
(2) Determination of serum alanine aminotransferase (ALT, GPT, alanine aminotransferase) activity:
This enzyme in the liver is 10,000 times higher than the blood concentration. In liver lesions, the permeability of the hepatocyte membrane increases, and the liver transaminase is released into the blood, which increases the serum enzyme content. The increase in this enzyme often reflects the degree of hepatocyte damage. Normal value: 5-25 units (generally 40 or less).
(3) Determination of total serum protein, albumin and globulin ratio:
In acute and chronic hepatitis, albumin synthesis is reduced, globulin is unchanged or increased, total protein is normal or decreased; albumin/globulin ratio (A/G) is changed or inverted.
Normal value: total protein 60-80 g / liter; albumin 35-55 g / liter, globulin 20-30 g / liter; white / ball ratio of 1.5: 1-2.5: 1.
(4) Thymol turbidity test (TTT).
Diagnosis
Diagnosis and identification of fulminant hepatitis-like syndrome
It should be mainly identified with viral hepatitis.
The course of the disease is different. The course of the disease is acute hepatitis within 6 months. The course of disease is more than 6 months. The hepatitis A and E virus hepatitis are only acute hepatitis B type C virus. The manifestations of acute hepatitis or chronic hepatitis, and the possibility of developing cirrhosis and hepatocellular carcinoma. It should be noted that due to the latent nature of viral infection, for patients with hepatitis B, C, and D virus, even if the patient cannot provide a history of more than 6 months, the possibility of chronic hepatitis may not be ruled out.
