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THE NATURAL HISTORY OF ISCHEMIC HEPATITIS

Although poor hepatic perfusion from low cardiac output may result in ischemic hepatitis in adults, this syndrome has not previously been described in children. We report 16 children who developed liver dysfunction compatable with ischemic hepatitis. A summary of laboratory findings is presented below.In children with ischemic hepatitis, the SGOT increased to 10x normal within 12 hours in 8 and peaked at greater than 1000 IU/L in 8/16. Although total bilirubin exceeded 4.0 mg/dl in only 3 children, in those 3 it was very high (12, 24, 28 mg/dl). SCOT fell below 100 IU/L by 10 days in 8/16. Conditions resulting in ischemic hepatitis included: prolonged seizures 4, cardiac disorders 4, near drowing 3, septic shock 2, hypovoluemia 1, SIDS ], and hypothermia ]. Documented hypotension occurred in 13/16 and required pressor therapy in 9 cases. Hepatomegally developed in 12 and jaundice in 5. Although 5 children died, no deaths were related to hepatic failure.CONCLUSION: Ischemic hepatitis follows a charac taristic and benign course in children. Resolution of abnormal liver function is rapid.