Fulminant Hepatitis

Fulminant Hepatitis

Fulminant hepatitis is liver damage from hepatitis caused by viruses, alcohol, or drugs. This liver damage occurs rapidly within weeks or even days.

Fulminant hepatitis , also known as acute liver failure, is a rare disease. This disease usually occurs in people who previously had no history of liver problems or chronic hepatitis.

Patients with fulminant hepatitis need to get treatment immediately to avoid fatal complications.

Causes of Fulminant Hepatitis

Fulminant hepatitis occurs when liver cells are damaged so that the liver cannot work properly. As a result, toxins that should be removed through metabolic processes instead accumulate in the body.

Fulminant hepatitis is generally caused by:

Overdosis paracetamol

Paracetamol overdose can occur due to consuming paracetamol in excessive doses or every day for a long time.

Hepatitis infection

Fulminant hepatitis can also be a complication due to hepatitis B and D infection that occurs simultaneously (co-infection). Although rare, fulminant hepatitis can also be caused by hepatitis A, C, and E infection .

In addition, there are several factors that can increase the risk of hepatitis fulmina, including:

  • Side effects of drugs, such as antibiotics, non-steroidal anti-inflammatory drugs ( NSAIDs ), and anti-seizures
  • Herbal products, such as kava, ephedra, and pennyroyal
  • Viral infections, such as Epstein-Barr virus, cytomegalovirus , parvovirus B19, dengue virus, and herpes simplex virus
  • Medical conditions, such as autoimmune hepatitis, Wilson's disease , cancer that has spread to the liver, and Budd-Chiari syndrome
  • Certain mushroom poisoning, such as Amanita phalloides ( deathcap mushroom )

Symptoms of Fulminant Hepatitis

In its early stages, fulminant hepatitis can cause the following symptoms:

  • Fever
  • Weak
  • The body gets tired easily
  • Abdominal pain in the upper right
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea

As the disease progresses, other symptoms that may appear include:

  • Dark urine
  • Stomach swelling ( ascites )
  • The skin experiences itching
  • The skin bruises or bleeds easily
  • The skin and the whites of the eyes turn yellow ( jaundice )
  • Changes in mental state, personality, or behavior
  • Easy to sleepy
  • Bewildered
  • Come

When to go to the doctor

Fulminant hepatitis can progress quickly and can be life-threatening. Therefore, if you or those around you experience the symptoms of fulminant hepatitis as mentioned above, immediately consult a doctor .

Diagnosis of Fulminant Hepatitis

To diagnose fulminant hepatitis, the doctor will first ask the patient about medical history, history of drug use, and possible exposure to certain toxic substances. Furthermore, the doctor will also carry out a physical examination of the symptoms that appear and the patient's state of consciousness.

After that, the doctor will carry out several supporting examinations, such as:

  • Blood tests , to check liver function and blood clotting function which can be disrupted due to liver damage
  • Scanning tests, by ultrasound , CT scan, or MRI, to see the condition of the liver, and detect tumors around the liver or other organs
  • Liver biopsy, to detect the cause of fulminant hepatitis by examining a sample of liver tissue

Treatment of Fulminant Hepatitis

Generally, treatment for fulminant hepatitis will be carried out in a hospital intensive care unit (ICU). The goal of treatment is to treat the underlying cause of this disease.

If the patient has decreased consciousness or is in a coma, the doctor will first stabilize the patient's condition by:

  • Provide special fluid infusion
  • Installing breathing apparatus, such as a ventilator
  • Give heart stabilizing drugs and blood pressure
  • Installing the probe hose

If the patient is stable, several treatment methods that can be given by doctors include:


Doctors will give N-acetylcysteine ​​to patients who experience fulminant hepatitis due to an overdose of paracetamol.

Meanwhile, in fulminant hepatitis caused by hepatitis B infection, doctors will give antiviral drugs, such as lamivudine . Meanwhile, if fulminant hepatitis occurs due to autoimmune hepatitis, the doctor will give corticosteroid class drugs or drugs that suppress the immune system ( immunosuppressants ).

Liver transplant

If fulminant hepatitis has progressed to cause severe liver damage, the doctor may suggest a liver transplant procedure .

Fulminant hepatitis complications

Some of the complications that occur if fulminant hepatitis is not treated immediately are:

  • Heavy bleeding
  • Liver failure
  • Hepatic encephalopathy
  • Death

Prevention of Fulminant Hepatitis

Although the occurrence of fulminant hepatitis cannot always be avoided, there are several prevention measures that can be taken, including:

  • Get vaccinated against hepatitis A and B
  • Avoid taking drugs without advice from a doctor
  • Do not consume alcoholic beverages
  • Apply clean and healthy living behavior ( PHBS ) to prevent infection
  • Cooking food until done
  • Implement healthy sexual behavior
  • Do not use drugs
  • Do not snack carelessly
  • Get regular treatment and control to the doctor if you suffer from an autoimmune disease
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