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VOLUME 6 , ISSUE 2 ( July-December, 2016 ) > List of Articles


Profile of Acute Liver Failure from North-east India and Its Differences from other Parts of the Country

Premashish Kar, Anup K Das, Tarjina Begum, Anupam Dutta

Citation Information : Kar P, K Das A, Begum T, Dutta A. Profile of Acute Liver Failure from North-east India and Its Differences from other Parts of the Country. Euroasian J Hepatogastroenterol 2016; 6 (2):111-115.

DOI: 10.5005/jp-journals-10018-1181

License: CC BY-NC 4.0

Published Online: 01-05-2010

Copyright Statement:  Copyright © 2016; The Author(s).


Background: Acute liver failure (ALF) is a critical illness with a large number of viral and nonviral causes. Clinical course and etiologies in the Asian countries are different from those reported from the Western world and mortality is high. There may even be intracountry variations in large countries like India, which have differing culture, ethnicity, and environment. Data from North-east part of India is lacking. Materials and methods: Acute liver failure cases (>14 years of age) seen over a period of 8 years (n = 255) were studied at a Government Medical College in Assam for their etiological and other demographic profile. Viral serology was carried out and revalidated at a laboratory in New Delhi. Results: Majority of cases were <30 years of age. Commonest etiology was nonviral (non-ABCE). Amongst viral causes, hepatitis A and E were common, while hepatitis B virus (HBV) was rare. Unknown herbal medication use was very frequent in our cases with a significantly higher mortality. Mortality was highest in cases in 3rd decade of life. Statistically, international normalized ratio (INR) was the strongest predictor of death. Conclusion: Unlike the rest of India, hepatitis virus is not the major cause of ALF in our part; hepatitis A being commoner than hepatitis E, and B is rare. Unknown herbal medications are major cause of mortality and is important medicosocial issue. Our study highlights the differences in the profile of ALF from other Indian and western studies, possibly due to sociocultural factors prevalent in this part.

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  1. Gill RQ, Sterling RK. Acute liver failure. J Clin Gastroenterol 2001 Sep;33(3):191-198
  2. Acute liver failure. N Engl J Med 2013 Dec;369(26):2525-2534
  3. Acute liver failure: redefining the syndromes. Lancet 1993 Jul;342(8866):273-275
  4. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989 Aug;97(2):439-445
  5. Fulminant hepatitis in a tropical population: clinical course, cause, and early predictors of outcome. Hepatology 1996 Jun;23(6):1448-1455
  6. Etiologies of acute liver failure. Semin Liver Dis 2008 May;28(2):142-152. Profile of Acute Liver Failure from North-east India and Its Differences from other Parts of the Country Euroasian Journal of Hepato-Gastroenterology, July-December 2016;6(2):111-115 115 EJOHG 7. Dhiman RK, Seth AK, Jain S, Chawla YK, Dilawari JB. Prognostic evaluation of early indicators in fulminant hepatic failure by multivariate analysis. Dig Dis Sci 1998 Jun;43(6): 1311-1316
  7. Changing patterns of aetiology of acute sporadic viral hepatitis in India – newer insights from north-east India. Int J Curr Res Rev 2014;6(19):14-20
  8. Etiologies of acute liver failure. Curr Opin Crit Care 2008 Apr;14(2):198-201
  9. Acute hepatic failure in India: a perspective from the East. J Gastroenterol Hepatol 2000 May;15(5):473-479
  10. Etiopathogenesis of acute hepatic failure: Eastern versus Western countries. J Gastroenterol Hepatol 2002 Dec;17 (Suppl 3):S268-273
  11. Hepatitis virus Non A Non B: the cause of a major public health problem in India. Bull World Health Organ 1985;63(5):931-934
  12. Changing etiologies and outcomes of acute liver failure: a perspective from Japan. J Gastroenterol Hepatol 2011 Jan;26 (Suppl 1):65-71
  13. Acute hepatic failure: a Western perspective. J Gastroenterol Hepatol 2000 May;15(5):480-488
  14. Drug-induced liver injury: present and future. Clin Mol Hepatol 2012 Sep;18(3):249-257
  15. Drug- and herb-induced liver injury: a case series from a single center. Turk J Gastroenterol 2014 Feb;25(1):41-45
  16. A prospective nationwide study of drug-induced liver injury in Korea. Am J Gastroenterol 2012 Sep;107(9):1380-1387
  17. Preliminary multicenter study about toxic hepatitis in Korea. Korean J Hepatol 2004;10(Suppl 2):80-86
  18. Idiosyncratic drug hepatotoxicity. Nat Rev Drug Discov 2005 Jun;4(6):489-499
  19. Pharmacogenetics of drug-induced liver injury. Hepatology 2010 Aug;52(2): 748-761
  20. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Hepatology 2010 Dec;52(6): 2065-2076
  21. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 2002 Dec;137(12):947-954
  22. Fulminant hepatic failure. Lancet 1997 Apr;349(9058):1081
  23. Fulminant hepatic failure: summary of a workshop. Hepatology 1995 Jan;21(1):240.
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