Fulminant hepatitis is a life-threatening condition defined by significantly impaired liver function. The rapid onset of fulminant hepatitis, also known as acute liver failure, necessitates immediate medical attention to prevent complications, including death. Depending on the extent of liver impairment, medication may be administered to restore liver function. If liver impairment is irreversible, a liver transplant may be necessary to ensure survival.
Potentially fatal liver failure can develop in a matter of hours, so a timely diagnosis of fulminant hepatitis is essential. Blood tests are performed to check for markers of infection and other abnormalities, such as delayed clotting. When the liver is functioning properly, it aids with blood coagulation. If liver function is compromised, blood clotting is diminished. A hepatic, or liver, tissue sample may also be obtained and examined for inflammation, scarring, and other abnormal hepatic activity.
Acute liver failure usually starts with a significant injury to the liver. Although most cases of fulminant hepatitis are idiopathic, meaning there is no definitive, identifiable cause for its onset, there are factors that may increase one’s risk for illness. The excessive use of acetaminophen-based, over-the-counter (OTC) analgesic medications and certain prescription drugs, including anticonvulsants, can contribute to acute liver failure. Vascular and metabolic conditions may also instigate extensive liver inflammation resulting in organ failure. It is not uncommon for viral infections, including herpes simplex virus and Epstein-Barr, to precipitate fulminant hepatitis.
Individuals with fulminant hepatitis will exhibit varying degrees of patterned signs and symptoms. The most recognizable sign of liver failure is jaundice, which is the yellowing of one’s eyes and skin. Before jaundiced skin and eyes are noticeable, individuals experience nausea, abdominal discomfort, and pronounced fatigue brought on by little physical exertion. Additional signs may include malaise and impaired cognition.
If signs of fulminant hepatitis are ignored, individuals are considered at significant risk for complications. Inadequate blood clotting can complicate existing conditions, including bleeding ulcers. Individuals with compromised liver function are also more susceptible to infection and have greater difficulty fighting off infection. Additional complications can include cerebral edema, renal failure, and death.
Fulminant hepatitis triggered by toxicity, such as may occur with aspirin overdose, may be reversed with drug therapy. Complications of acute liver failure must be treated in a timely fashion to prevent a worsening of symptoms. Antibiotic medication and coagulants may be administered to eliminate infection and aid with blood clotting. Individuals whose liver failure is deemed irreversible may undergo liver transplantation.