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Fulminant hepatitis: causes, symptoms, diagnosis, treatment

Medical expert of the article

Hepatologist
, medical expert
Last reviewed: 05.07.2025

Fulminant hepatitis is a rare syndrome of massive necrosis of the liver parenchyma with a reduction in its size (acute yellow atrophy), which usually occurs with viral hepatitis or when exposed to toxic substances or drugs.

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What causes fulminant hepatitis?

Fulminant hepatitis is sometimes caused by HBV, and up to 50% of cases of fulminant hepatitis B are co-infected with HDV. Fulminant hepatitis with HAV is rare, but may occur in people with underlying liver disease. The role of HCV remains unclear.

Symptoms of fulminant hepatitis

Patients rapidly deteriorate due to the development of portosystemic encephalopathy, often progressing to coma within hours or days, sometimes with cerebral edema. Bleeding is usually due to liver failure or disseminated intravascular coagulation and functional renal failure (hepatorenal syndrome). Increased PT, portosystemic encephalopathy, and especially renal failure are poor prognostic signs.

Where does it hurt?

What do need to examine?

Treatment of fulminant hepatitis

With careful care and aggressive treatment of complications, the outcome may be more favorable. However, only emergency liver transplantation provides the best chance of recovery. Adult patients rarely survive without a liver transplant; children have a better chance. Patients who survive usually recover completely.


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