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Fixed point observation of etiology of acute liver failure according to the novel J apanese diagnostic criteria
Author(s) -
Fujiwara Keiichi,
Yasui Shin,
Yonemitsu Yutaka,
Arai Makoto,
Kanda Tatsuo,
Nakano Masayuki,
Oda Shigeto,
Yokosuka Osamu
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.178
Subject(s) - etiology , medicine , coma (optics) , gastroenterology , hepatitis , indeterminate , pediatrics , physics , mathematics , pure mathematics , optics
Background There has existed important differences in the definition of acute liver failure ( ALF ) between J apanese criteria and those of other countries. The novel diagnostic criteria for ALF in J apanese patients were established by the I ntractable H epato‐ B iliary D iseases S tudy G roup of J apan, in order to correspond to those for ALF in E urope and the USA. We prospectively diagnosed our ALF patients based on this novel criteria, and discussed the etiology by a fixed point observation. Methods We investigated the etiology of 54 adult inpatients and outpatients with ALF between 2010 and 2012. Results Of 54 patients, 36 were ALF without coma, 17 ALF with coma and one late onset hepatic failure. The etiology was due to viral infections in 38.9%, autoimmune hepatitis in 11.1%, drug‐induced liver injury in 13.0%, etiologies without hepatitis in 29.6% (circulatory disturbance in 18.5%, infiltration of the liver by malignant cells in 7.4%, and metabolic diseases in 3.7%) and indeterminate causes in 7.4%. Conclusions Circulatory disturbance was the most frequent etiology according to the novel criteria. Indeterminate etiology was less observed in our study than the nation‐wide survey with significance ( P = 0.0014).