HALOTHANE HEPATITIS IN CHILDREN

被引:13
作者
HASSALL, E
ISRAEL, DM
GUNASEKARAN, T
STEWARD, D
机构
[1] UNIV BRITISH COLUMBIA,DEPT ANESTHESIA,VANCOUVER V6T 1W5,BC,CANADA
[2] UNIV BRITISH COLUMBIA,DEPT PEDIAT,VANCOUVER V6T 1W5,BC,CANADA
[3] UNIV BRITISH COLUMBIA,DIV PEDIAT GASTROENTEROL,VANCOUVER V6T 1W5,BC,CANADA
关键词
Halothane; Hepatitis;
D O I
10.1097/00005176-199011000-00019
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Halothane hepatitis is now a well-recognized distinct entity in adults, but there prevails an often-taught "axiom" that halothane hepatitis “does not occur” in children. We describe 2 children who developed cholestatic hepatitis following halothane anesthesia. The first patient had no antecedent liver disease, and presented with anorexia, abdominal pain and delayed onset of jaundice after multiple halothane exposures. Halothane-specific antibodies were positive, and liver tests resolved completely. The second patient had antecedent liver disease and presented with delayed onset of unexplained high fevers for 10 days following a single halothane exposure. Gradually increasing cholestasis ensued in the absence of other causes of liver disease. Halothane anti-bodies were negative. These cases illustrate different clin-ical presentations of halothane hepatitis, such as delayed onset of jaundice or fever following halothane exposure. The difficulties in making a definitive diagnosis and the need to exclude other causes of liver disease are detailed. Risk factors and other presentations are discussed. While halothane hepatitis appears to be an uncommon entity in children, it does occur, and may present with manifestations less than fulminant hepatic failure. A high index of suspicion and a detailed history of the time sequence of events are necessary as the diagnosis is primarily clinical. Halothane-specific antibodies are helpful if positive. In any child developing unexplained jaundice or high fevers following halothane anesthesia, further exposures should be avoided and halothane-specific antibodies obtained. © 1990 Raven Press, Ltd., New York.
引用
收藏
页码:553 / 557
页数:5
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