Impact of fulminant hepatic failure in C-reactive protein?

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Introduction Fulminint hepatic (FHF) refers to the rapid development of severe acute liver injury with impaired synthetic function coagulopathy and encephalopathy in a person who previously had a normal liver or had a well compensated liver disease It is a rare complication in critically ill patients and carries a very bad prognosis Serum C reactive protein (CRP) a useful marker of infection is produced exclusively by the liver Aim The aim of this study was to assess CRP concentrations in patients with FHF Methods We prospectively identified patients with sepsis and FHF treated at the intensive care unit (ICU) Data collected included admission diagnosis medical history systemic inflammatory response syndrome critical. Acute Physiologic and Chronic Health Evaluation II and Sequential OIT, in Failure Assessment scores C reactive protein and white cell count were measured a admission and then daily until ICU discharge Results We included 7 patients with FHF and sepsis Six patients died with severe multiple organ future Six patients were already admitted with FHF with the remining one being diagnosed at the 26th day of ICU stay All patients present severe coagulopathy In all septic patients despite clinical deterioration CRP levels were markedly decreased sometimes reaching undetectable levels. Conclusion In septic patients with FHF CRP is more a marker of severe liver dysfunction and should not be used is a marker of infection As a result on a patient admitted with a very high suspicion of infection and an abnormally low CRP concentration or with a marked CRP decline despite persistent septic shock severe hepatic future should be ruled out (C) 2010 Elsevier Inc. All rights reserved.
Original languageUnknown
Pages (from-to)e7-12
JournalJournal of critical care
Issue number4
Publication statusPublished - 1 Jan 2010

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