Fulminant Hepatitis Like syndrome refers to a group of non-viral hepatitis conditions that exhibit manifestations similar to fulminant hepatitis. This includes conditions such as acute fatty liver of pregnancy, tetracycline-induced toxic hepatitis, and Reye's syndrome. However, if treated successfully, the liver can fully recover. This group of disorders is characterized by acute onset, grade III nausea, vomiting, abdominal distension and fullness, bleeding tendencies, and consciousness disturbances.

bubble_chart Pathological Changes

Pathologically, the liver exhibits an appearance of acute yellow liver atrophy.

bubble_chart Clinical Manifestations

1. Acute fatty liver of pregnancy

The patients are mostly primiparas aged 20-30 years. In the advanced stage of pregnancy (36-40 weeks), they suddenly develop facial edema, proteinuria, and hypertension, followed by upper abdominal pain, nausea, vomiting, bleeding tendency, progressively deepening jaundice, and impaired consciousness. Characteristic features include significantly elevated blood bilirubin, negative urine bilirubin, normal ALT levels, and frequent hypoglycemia. The mortality rate is as high as 70-80%. Causes of death may include acute liver and kidney failure, fatal hypoglycemia, DIC, hemorrhagic pancreatitis, and gastrointestinal bleeding.

2. Acute fatty liver caused by tetracycline poisoning

The ingestion of large amounts of tetracycline antibiotics can lead to acute fatty liver, especially in pregnant women. Pathological manifestations include diffuse fatty degeneration, hepatocyte necrosis, and cholestasis. Clinical symptoms include sudden fever, jaundice, and impaired consciousness.

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Also known as encephalopathy fatty liver syndrome, it refers to brain edema and fatty deposition in organs such as the liver and kidneys caused by viruses, toxins, and metabolic disorders. Clinically, children first exhibit common cold-like prodromal symptoms, followed by frequent vomiting accompanied by severe headache 2 days to 3 weeks later, and then develop symptoms such as liver dysfunction and impaired consciousness.

bubble_chart Treatment Measures

First, discontinue all medications that cause liver injury and provide a light diet rich in vitamins. Maintain water, electrolyte, and acid-base balance, and manage symptoms such as shock. Lower blood ammonia levels to correct amino acid imbalance. For cerebral edema, use mannitol to reduce intracranial pressure. If necessary, perform seasonal epidemic dialysis or exchange transfusion therapy.