News - AASLD Research Identifies Keys to Distinguishing Between Acute Liver Fai
- AASLD: Research Identifies Keys to Distinguishing Between Acute Liver Failure and Viral Hepatitis in Pregnancy
By Maria Bishop
BOSTON, MA -- November 3, 2004 -- Although there is significant overlap in the clinical and biochemical features of pregnancy-associated acute liver failure (PAALF) and viral hepatitis (VH) in pregnancy, clinicians can look to jaundice, platelet count, ascites, hypertension and albumin as predictors for distinguishing between the two conditions.
PAALF is an umbrella term that includes acute fatty liver of pregnancy and hemolysis elevated-liver-enzyme low-platelet syndrome.
Harshad C. Devarbhavi, MD, Department of Gastroenterology and Hepatology, Mayo Clinic Foundation, Rochester, Minnesota, reported the study results here on November 1st at the 55th Annual Meeting of the American Society for Liver Diseases.
The researchers analysed the clinical and laboratory features of 46 patients with PAALF and 42 patients with viral hepatitis in pregnancy (68% hepatitis E and 32% hepatitis B) seen between January 2000 and July 2003 at St. John's Medical College Hospital, Bangalore, India.
Results show that, in pregnant patients with jaundice, there is a 97% concordance of platelet count, ascites, hypertension and albumin as valuable predictors between PAALF and viral hepatitis in pregnancy. Admission platelet count alone had a concordance of 88%.
For women with PAALF, univariate analysis showed that there is a greater prevalence of encephalopathy, hypertension, oliguria, ascites, maternal and intra-uterine death, increased bilirubin, aspartate aminotransferase, alanine aminotransferase, prothrombin time, white-blood-cell count, lactase dehydrogenase, fibrin degeneration products, and low platelets than in the viral hepatitis group.
It is critical that physicians make an early and accurate diagnosis of PAALF, Dr. Devarbhavi said, because there is a risk of high morbidity and mortality to both the fetus and mother. Early recognition and prompt delivery of the infant are the cornerstones of therapy for this condition, he said, and supportive measures only are required in treating pregnant women with viral.
[Presentation title: "Pregnancy-Associated Acute Liver Failure and Viral Hepatitis: Differentiation and Outcome." Abstract 777]
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