[Fulminant hepatitis: pathogenesis, clinical aspects and management].

Fulminant hepatic failure may develop as a complication of liver disease of various etiology. Infectious agents, drugs and liver toxins represent the major causes of fulminant hepatitis. The function of many organ systems may be impaired during acute hepatic failure because of the crucial role of the liver in intermediary metabolism. The mortality of 50% or more is mainly due to cerebral edema, bleeding from the gastrointestinal tract or disseminated infections. In this review the causes, complications and pathophysiology of fulminant hepatitis are discussed, with particular reference to the prevention of complications and to therapeutic strategies. Moreover, criteria for assessment of prognosis are discussed. A case report illustrates the complex clinical picture and frequently fatal outcome of the disease.