Colleti Junior José, Caino Felipe Rezende, Teixeira Rafael, Carvalho Werther Brunow de
Department of Pediatrics, Santa Catarina Hospital, São Paulo, SP, Brasil.
Pediatric ICU, Assunção Hospital, São Bernardo do Campo, São Paulo, SP, Brasil.
Rev Assoc Med Bras (1992). 2019 Jul 22;65(6):914-921. doi: 10.1590/1806-9282.65.6.914.
The objective of this review was to investigate the epidemiology of Fulminant Acute Hepatitis in Latin America and the Caribbean and identify possible measures aimed at a better understanding and improvement of patient support.
We used 3 different researchers to investigate the topic of Fulminant Acute Hepatitis in pediatrics in papers published by Latin American and Caribbean authors in the PubMed and SciELO databases from 2000 to 2016.
We found 2,879 articles in the databases searched. After selecting and excluding articles according to the study protocol, 68 remaining studies were obtained for analysis. A total of 1,265 cases of acute fulminant hepatitis were detected, with a predominance of females (42.9%), followed by males (39.4%), with no description of sex in 17.7% of the cases. The main cause was viral hepatitis, representing 45.1% of the cases. The hepatitis A virus was responsible for 34.7% of the total cases and 76.9% of the infectious causes. Of the total number of patients, 26.9% were described as idiopathic, and 11.5% had no cause.
The preventable causes of Fulminant Acute Hepatitis include hepatitis viruses - primarily the hepatitis A virus - and poisoning. Active vaccination, basic sanitation, and public awareness can reduce the number of patients and, consequently, the costs of liver transplantation due to these causes.
本综述的目的是调查拉丁美洲和加勒比地区暴发性急性肝炎的流行病学情况，并确定旨在更好地理解和改善患者支持的可能措施。
我们使用3名不同的研究人员，对2000年至2016年拉丁美洲和加勒比地区作者在PubMed和SciELO数据库上发表的关于儿科暴发性急性肝炎主题的论文进行研究。
在检索的数据库中我们发现了2879篇文章。根据研究方案筛选并排除文章后，共获得68项研究用于分析。总共检测到1265例急性暴发性肝炎病例，其中女性占主导（42.9%），其次是男性（39.4%），17.7%的病例未描述性别。主要病因是病毒性肝炎，占病例的45.1%。甲型肝炎病毒占总病例的34.7%，占感染性病因的76.9%。在所有患者中，26.9%被描述为特发性，11.5%病因不明。
暴发性急性肝炎的可预防病因包括肝炎病毒——主要是甲型肝炎病毒——以及中毒。积极接种疫苗、基本卫生设施和公众意识可以减少患者数量，从而降低因这些病因进行肝移植的费用。
