hepatic and biliary disorders
Fulminant Hepatitis
Introduction
Fulminant hepatitis is a rare syndrome of rapid (usually within days or weeks), massive necrosis of liver parenchyma and a decrease in liver size (acute yellow atrophy); it usually occurs after infection with certain hepatitis viruses, alcoholic hepatitis, or drug-induced liver injury (DILI). (See also Evaluation of the Patient With a Liver Disorder and Hepatitis B virus is sometimes responsible for fulminant hepatitis, and up to 50% of cases of fulminant hepatitis B involve hepatitis D virus coinfection. Fulminant hepatitis with hepatitis A virus is rare but may be more likely in people with preexisting liver disorders. Occasionally, hepatitis E virus causes fulminant hepatitis, especially in pregnant women, potentially leading to fetal loss, liver failure, and death. The role of hepatitis C virus remains uncertain. Alcoholic hepatitis may cause fulminant liver failure, but most patients have a long history of heavy drinking and so probably have underlying chronic liver disease. Drugs (especially Acute Acetaminophen Poisoning ) are the most common cause of fulminant hepatitis in the US. 