Ischemic hepatitis in children: diagnosis and clinical course. Crit Care Med 1988 Dec;16(12):1209-12
Date
12/01/1988Pubmed ID
3191736DOI
10.1097/00003246-198812000-00006Scopus ID
2-s2.0-0024270477 (requires institutional sign-in at Scopus site) 36 CitationsAbstract
Hepatic hypoperfusion can result in ischemic hepatitis, a clinical syndrome characterized by a sudden rise in serum transaminases followed by resolution to near normal levels within 7 to 10 days. Although described in adults, this syndrome has not been well defined in pediatric patients. We report 22 children who developed ischemic hepatitis during an acute illness. Fifteen of 22 patients had a documented hypotensive episode or no cardiac output before the onset of the ischemic hepatitis episode. Four of the seven patients without documented hypotension required pressor therapy to maintain their BP. SGOT showed a marked rise (mean 2294 IU/L, range 438 to 6652) from admission to 96 h (mean 34) with a rapid decline to near normal levels within 9 days (mean 5.1). Serum bilirubin levels also rose transiently, but generally not to the extent of transaminase levels. A clinically significant coagulopathy occurred in six patients. Although nine patients expired, none died as a direct result of the hepatic damage. Ischemic hepatitis can occur during illnesses associated with diminished hepatic blood flow and follows a characteristic course that usually can be differentiated from viral or drug-induced hepatitis on clinical and biochemical criteria.
Author List
Garland JS, Werlin SL, Rice TBAuthors
Thomas Rice MD Emeritus Professor in the Pediatrics department at Medical College of WisconsinSteven L. Werlin MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAlanine Transaminase
Aspartate Aminotransferases
Child
Child, Preschool
Female
Hepatitis
Humans
Infant
Infant, Newborn
Intensive Care Units
Ischemia
Liver
Liver Function Tests
Male
Medical Records
Prognosis
