Fulminant hepatitis type B, complicated by acute renal failure prior to hepatic coma onset: Report of two cases

Two cases of fulminant hepatitis type B complicated by acute renal failure prior to hepatic coma onset were encountered. The first case was a 31 year-old male, who had been given a blood transfusion following gastrointestinal bleeding. One and half months later, he was admitted to this hospital with liver dysfunction, anuria and encephalopathy. Laboratory tests revealed a PT of 15.8% and HBs antigen (+). Fulminant hepatitis type B was diagnosed, and he subsequently underwent in ICU. Although encephalopathy progressed to hepatic coma grade V, the patient survived. The second case was a 50 year-old male who was admitted to this hospital with anuria. After admission, he developed encephalopathy. A laboratory examination revealed a PT of 12.0% and HBs antigen (+), consequently fulminant hepatitis type B was diagnosed. Although liver function recovered (PT=71.5%) after ICU treatment, the patient died of DIC due to pulmonary hemorrhage. Cases of fulminant hepatitis complicated by acute renal failure, have a very poor prognosis. However, in our experience, one case recovered, and the other case with respect to liver function tests.