Y Wang1, Y Chen, C Gu, L Jiang, D Xiang. 1. Center for Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Abstract
OBJECTIVE: To explore the possibility of establishing more reasonable nomenclatures and diagnostic criteria for patients with severe hepatitis (SH) through analyzing clinical data of 477 cases of SH. METHODS: The clinical characteristics and outcomes of SH were analyzed according to different criteria. RESULTS: Chronic severe hepatitis (CSH) made up 88.5% of total cases of SH. The survival rate in the patients with hepatic encephalopathy was much lower than that without hepatic encephalopathy. About 1/5 of cases of subacute severe hepatitis (SSH) and CSH had neither ascites nor hepatic encephalopathy. When the period of 2 weeks was used in replace of 10 days for the diagnosis for acute severe hepatitis (ASH), the newly added cases were consistent with the characteristics of ASH. CONCLUSION: We suggest dividing SH into 2 types: encephalopathy and non-encephalopathy by using the nomenclature of fulminant hepatitis and severe type hepatitis, respectively. The late-onset form should be added besides of acute form and subacute form. It seems to use the period of 2 weeks as the new definition of onset time for ASH. The criteria of dividing SH into 3 forms, i.e. ascites, encephalopathy and ascites plus encephalopathy, and the nomenclature recommended by the International Association for the Study of the Liver Subcommittee are not satisfactory when used in clinical cases. The typing of CSH remains to be clarified.
OBJECTIVE: To explore the possibility of establishing more reasonable nomenclatures and diagnostic criteria for patients with severe hepatitis (SH) through analyzing clinical data of 477 cases of SH. METHODS: The clinical characteristics and outcomes of SH were analyzed according to different criteria. RESULTS:Chronic severe hepatitis (CSH) made up 88.5% of total cases of SH. The survival rate in the patients with hepatic encephalopathy was much lower than that without hepatic encephalopathy. About 1/5 of cases of subacute severe hepatitis (SSH) and CSH had neither ascites nor hepatic encephalopathy. When the period of 2 weeks was used in replace of 10 days for the diagnosis for acute severe hepatitis (ASH), the newly added cases were consistent with the characteristics of ASH. CONCLUSION: We suggest dividing SH into 2 types: encephalopathy and non-encephalopathy by using the nomenclature of fulminant hepatitis and severe type hepatitis, respectively. The late-onset form should be added besides of acute form and subacute form. It seems to use the period of 2 weeks as the new definition of onset time for ASH. The criteria of dividing SH into 3 forms, i.e. ascites, encephalopathy and ascites plus encephalopathy, and the nomenclature recommended by the International Association for the Study of the Liver Subcommittee are not satisfactory when used in clinical cases. The typing of CSH remains to be clarified.