Everyone Healthy Library
Fulminant Hepatitis
Condition / disease reference page from the Everyone Healthy database.
! Seek urgent medical care if warning signs appear
Some health conditions or symptoms can become urgent. Use this page for education, but seek help quickly if warning signs are present.
Get urgent medical care now if there is any severe, sudden, rapidly worsening or worrying symptom, especially:
- chest pain, pressure or pain spreading to the arm, jaw or back
- trouble breathing, blue lips, severe wheeze or choking
- stroke-like symptoms such as face drooping, arm weakness or speech trouble
- collapse, fainting, seizure, confusion or extreme drowsiness
- severe bleeding, black stools, vomiting blood or major injury
- severe allergic reaction, swelling of the face/throat or widespread rash with breathing trouble
- severe abdominal pain, severe headache, stiff neck or sudden vision change
- signs of severe dehydration, sepsis, high fever with worsening illness, or symptoms in a baby/young child that concern you
Connected health information
Explore this condition in a clear order
Linked signs and symptoms
19Each sign/symptom opens its own page and links back to related conditions.
- Abdominal Swelling
- Appetite Loss (Anorexia)
- Blood in Stool
- Blood Pressure Below Normal (Hypotension)
- Brain or Intracranial Pressure Increase
- Bruising (Contusion)
- Bruising Easily
- Cerebral Edema (Oedema)
- Eye Inner or Intraocular Pressure Increased (Papiloedema)
- Heart or Pulse Rate Raised (Tachycardia)
- Liver Enlarged Or Tender
- Mind: Malaise
- Nausea
- Pain Abdominal
- Pain Right Upper Quadrant
- Skin Itching
- Skin Yellowing (Jaundice)
- Urine Dark
- Weakness
Linked drugs / medications
0No linked drugs are listed yet.
Treatments, therapies and supportive options
14Grouped by treatment type. These are educational database links, not personal treatment recommendations. Evidence labels are shown only where stored in the EH database.
Surgery
2Medical therapy
7- Fluid input and output monitoringWeakly in Favour(Low Evidence)
- Intensive Care (ICU)Weakly in Favour(Low Evidence)
- Intracranial Pressure MonitoringWeakly in Favour(Low Evidence)
- Liver TransplantWeakly in Favour(Low Evidence)
- Mechanical VentilationWeakly in Favour(Low Evidence)
- Nursing CareWeakly in Favour(Low Evidence)
- Transjugular Intrahepatic Portosystemic Shunting (TIPS)Weakly in Favour(Low Evidence)
Linked diagnostic tests and investigations
61These are pulled from both EH diagnostic-test link tables, including the older large test-link table.
- Acid Phosphatase Concentration
- Activated Coagulation Time (ACT)
- Activated Partial Thromboplastin Time (APTT)
- Alkaline Phosphatase (ALP) Concentration
- Alpha-1 Antitrypsin (AAT) Concentration
- Alpha-Fetoprotein (AFP, Serum AFP, Blood)
- amylase concentration
- Antithrombin 111 (AT-111) Activity Test
- Apolipoprotein A Concentration
- Apolipoprotein B Concentration
- Aspartate Aminotransferase (AST) Concentration
- Blood Urea Nitrogen Tests
- Blood Uric Acid Concentration Test
- Cerebrospinal Fluid Glutamine Concentration (CSF Glutamine)
- Cholesterol Concentration
- Cholinesterase (Serum Acetylcholinesterase, Pseudocholinesterase)
- Coagulation Factor Assay (Blood Clotting Factors)
- Creatine Kinase Concentration
- D-Dimer Blood Test
- Fecal Urobilinogen Concentration
- Fibrin Degradation Products (FDPs, Fibrin Split Products, FSPs, Fibrin Breakdown Products, Fbps)
- Fibrin Monomers Test
- Fibrinogen Concentration test
- Gamma-Glutamyltransferase (GGT) Concentration
- Glucose Tolerance Test (GTT, OGTT, 120 Minutes After Glucose Load)
- Glucose Tolerance Test (GTT, OGTT, 160 Minutes After Glucose Load)
- Glucose Tolerance Test (GTT, OGTT, 30 Minutes After Glucose Load)
- Glucose Tolerance Test (GTT, OGTT, 60 Minutes After Glucose Load)
- Glucose Tolerance Test (GTT, OGTT, Fasting Glucose)
- Glucose Tolerance Test for Gestational Diabetes (1 Hour After Glucose Load)
- Glucose Tolerance Test for Gestational Diabetes (Fasting Glucose Value)
- Glucose, Blood (Fasting Blood Glucose)
- Glucose, Blood (Post Prandiol Blood Glucose Test, 2 Hour Post Meal Blood Glucose)
- Glucose, Blood (Random Blood Glucose Test)
- haptoglobin (Hp) concentration
- High Density Lipoprotein (HDL) Concentration
- Human Placental Lactogen Concentration (hPL, Chorionic Somatomammotropin)
- Insulin Concentration (Insulin Assay, Serum Insulin)
- Lactate Dehydrogenase Concentration
- lipase concentration
- Low Density Lipoprotein (LDL) Concentration
- Lymphocytes Count
- Osmolality, Blood (Serum Osmolality)
- Phenylketonuria Test
- Plasminogen Activity
- Potassium Concentration (K, Blood)
- Protein Electrophoresis (Blood, Serum Protein)
- Prothrombin Time (PT)
- Thyroglobulin (Tg) Concentration
- Thyroxine (Total T4) Concentration
- Thyroxine Binding Globulin Concentration (TBG, Thyroid Binding Globulin, Blood)
- Triiodothyronine (Free T3) Concentration
- Triiodothyronine (Total T3) Concentration
- Triiodothyronine Uptake Test
- Urine Amino Acid Concentration
- Urine bilirubin Concentration
- Urine Porphyrin Concentration
- Urine Sodium Quantitative (24hr)
- Urine Urobilinogen Concentration
- Vitamin B12 (VB12) Concentration
- White Blood Cell (WBC) Count
Biological markers/agents
89This visual map shows biological markers/agents reported as increased or decreased with this condition. These are educational relationships only; test results must be interpreted by a qualified clinician because ranges vary by lab, method, age, sex and clinical context.
Often increased
65- 1 Methylhistidine (Urine)Reference range exampleChild (0 - 16y): 450–3,200 µmol/L; Adult ( > 16y): 700–8,500 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- 3 Methylhistidine (Urine)Reference range exampleChild (0 - 16y): 420–1,400 µmol/L; Adult ( > 16y): 650–3,300 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Acid PhosphataseReference range exampleChild (0 - 16y), Male: 8.7–12.5 units/L; Adult ( > 16y), Male: 2.2–10.4 units/LLinked diagnostic testsAcid Phosphatase Concentration
- Alanine (Urine)Reference range exampleAdult ( > 16y): 1,500–7,000 µmol/L; Child (< 10y): 600–2,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Alkaline Phosphatase (ALP)Reference range exampleAdult ( > 16y), Female: 30–125 units/L; Adult ( > 16y), Male: 40–110 units/LLinked diagnostic testsAlkaline Phosphatase (ALP) Concentration
- Alpha Amino N Buryric Acid (Urine)Reference range exampleAdult ( > 16y): 0–350 µmol/L; Child (< 10y): 80–300 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Alpha Aminoadipic Acid (Urine)Reference range exampleAdult ( > 16y): 0–1,700 µmol/L; Child (< 10y): 240–800 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Alpha-1 Antintrypsin (AAT)Reference range exampleAdult ( > 16y): 90–215 mg/dLLinked diagnostic testsAlpha-1 Antitrypsin (AAT) Concentration
- Alpha-1-Globulin (Blood, Serum)Reference range exampleAll: 0.1–0.3 gm/dLLinked diagnostic testsProtein Electrophoresis (Blood, Serum Protein)
- Alpha-Fetoprotein (Non-Pregnant, Serum)Reference range exampleAll: 5–40 ng/mLLinked diagnostic testsAlpha-Fetoprotein (AFP, Serum AFP
- Antithrombin 111 (AT-111)Reference range exampleAdult ( > 16y): 90–110 %Linked diagnostic testsAntithrombin 111 (AT-111) Activity Test
- Apolipoprotein B (Apo B)Reference range exampleAdult ( > 16y), Female: 47–115 mg/dL; Adult ( > 16y), Male: 52–120 mg/dLLinked diagnostic testsApolipoprotein B Concentration
- Arginine (Urine)Reference range exampleChild (0 - 16y): 120–260 µmol/L; Adult ( > 16y): 140–650 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Asparagine (Urine)Reference range exampleChild (0 - 16y): 160–420 µmol/L; Adult ( > 16y): 350–1,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Aspartate Aminotransferase (AST)Reference range exampleAdult ( > 16y), Female: 10–25 units/L; Adult ( > 16y), Male: 10–35 units/LLinked diagnostic testsAspartate Aminotransferase (AST) Concentration
- Aspartic Acid (Urine)Reference range exampleChild (0 - 16y): 110–270 µmol/L; Adult ( > 16y): 150–900 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Carnosine (Urine)Reference range exampleChild (0 - 16y): 350–2,500 µmol/L; Adult ( > 16y): 170–1,300 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Cholesterol (Total)Reference range exampleInfant (0 - 1y): 75–180 mg/dL; Adult ( > 16y): 0–190 mg/dLLinked diagnostic testsCholesterol Concentration
- Citrulline (Urine)Reference range exampleChild (0 - 16y): 0–140 µmol/L; Adult ( > 16y): 0–100 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Coagulation Bleeding TimeReference range exampleAdult ( > 16y): 65–110 secondsLinked diagnostic testsActivated Coagulation Time (ACT)
- Cystine (Urine)Reference range exampleChild (0 - 16y): 120–540 µmol/L; Adult ( > 16y): 300–1,200 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- D-DimerReference range exampleAdult ( > 16y): 0–240 µg/LLinked diagnostic testsD-Dimer Blood Test
- Fibrin MonomersReference range example0–10,000 µg/LLinked diagnostic testsFibrin Monomers Test
- Fibrin Split ProductsReference range exampleAll: 0–1 mg/dLLinked diagnostic testsFibrin Degradation Products (FDPs, Fibrin Split Products
- Gamma-Glutamyltransferase (GGT)Reference range exampleAdult ( > 16y), Female: 6–30 units/L; Adult ( > 16y), Male: 6–38 units/LLinked diagnostic testsGamma-Glutamyltransferase (GGT) Concentration
- Glutamic Acid (Urine)Reference range exampleChild (0 - 16y): 135–240 µmol/L; Adult ( > 16y): 300–1,100 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Glutamine (Cerebrospinal Fluid, CSF)Reference range exampleAll: 8–9.2 mg/dLLinked diagnostic testsCerebrospinal Fluid Glutamine Concentration (CSF Glutamine)
- Glutamine (Urine)Reference range exampleChild (0 - 16y): 1,600–4,000 µmol/L; Adult ( > 16y): 3,000–10,500 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Glycine (Urine)Reference range exampleChild (0 - 16y): 2,000–8,500 µmol/L; Adult ( > 16y): 8,000–25,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Histidine (Urine)Reference range exampleChild (0 - 16y): 500–7,300 µmol/L; Adult ( > 16y): 5,000–16,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Human Placental Lactogen (HPL, Pregnancy Weaks 25 to 30)Reference range exampleAdult ( > 16y), Female: 2,300–6,100 µg/LLinked diagnostic testsHuman Placental Lactogen Concentration (hPL, Chorionic Somatomammotropin)
- Human Placental Lactogen (hPL, Pregnancy Weaks 31 to 35)Reference range exampleAdult ( > 16y), Female: 3,800–8,800 µg/LLinked diagnostic testsHuman Placental Lactogen Concentration (hPL, Chorionic Somatomammotropin)
- Human Placental Lactogen (hPL, Pregnancy Weaks 36 to 40)Reference range exampleAdult ( > 16y), Female: 4,900–8,600 µg/LLinked diagnostic testsHuman Placental Lactogen Concentration (hPL, Chorionic Somatomammotropin)
- Human Placental Lactogen (HPL, Pregnancy Weaks 5 to 25)Reference range exampleAdult ( > 16y), Female: 0–4,500 µg/LLinked diagnostic testsHuman Placental Lactogen Concentration (hPL, Chorionic Somatomammotropin)
- InsulinReference range exampleChild (0 - 16y): 3–15 µIU/mL; Adult ( > 16y): 6–28 µIU/mLLinked diagnostic testsInsulin Concentration (Insulin Assay, Serum Insulin)
- Isoleucine (Urine)Reference range exampleChild (0 - 16y): 40–150 µmol/L; Child (0 - 16y): 100–250 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Lactate Dehydrogenase (LDH)Reference range exampleInfant (0 - 1y): 120–250 units/L; Adult ( > 16y): 100–200 units/LLinked diagnostic testsLactate Dehydrogenase Concentration
- LipaseReference range exampleAdult ( > 16y): 10–140 units/LLinked diagnostic testslipase concentration
- Low Density Lipoprotein (LDL)Reference range exampleAdult ( > 16y): 0–125 mg/dL; 6y - 16y: 0–100 mg/dLLinked diagnostic testsLow Density Lipoprotein (LDL) Concentration
- LymphocytesReference range exampleAdult ( > 16y): 25–40 %; 700–3,500 cells/mm3Linked diagnostic testsDifferential White Blood Cell Count Tests, Lymphocytes Count
- Lysine (Urine)Reference range exampleChild (0 - 16y): 200–1,500 µmol/L; Adult ( > 16y): 300–3,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Methionine (Urine)Reference range exampleChild (0 - 16y): 70–220 µmol/L; Adult ( > 16y): 55–320 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Ornithine (Urine)Reference range exampleChild (0 - 16y): 40–165 µmol/L; Adult ( > 16y): 50–800 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Osmolality, Blood (Serum Osmolality)Reference range exampleChild (0 - 16y): 274–290 mOsm/kg; Birth - 2wks: 265–285 mOsm/kgLinked diagnostic testsOsmolality, Blood (Serum Osmolality)
- PhenylalanineReference range exampleAdult ( > 16y): 0–16 mg/24hrs; Child (5 - 12y): 4–16.5 mg/24hrsLinked diagnostic testsPhenylketonuria Test
- Phenylalanine (Urine)Reference range exampleChild (0 - 16y): 200–600 µmol/L; Adult ( > 16y): 400–1,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Phosphoethanolamine (Urine)Reference range exampleChild (0 - 16y): 250–670 µmol/L; Adult ( > 16y): 200–1,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Phosphoserine (Urine)Reference range exampleChild (0 - 16y): 150–350 µmol/L; Child (0 - 16y): 1,000–2,200 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Plasma thromboplastin antecedentReference range exampleAdult ( > 16y): 20–35 secondsLinked diagnostic testsActivated Partial Thromboplastin Time (APTT)
- Proline (Urine)Reference range exampleChild (0 - 16y): 0–1 Not PresentLinked diagnostic testsUrine Amino Acid Concentration
- Prothrombin TimeReference range exampleAdult ( > 16y): 10–13 secondsLinked diagnostic testsProthrombin Time (PT)
- Serine (Urine)Reference range exampleChild (0 - 16y): 1,000–2,200 µmol/L; Adult ( > 16y): 2,000–7,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Taurine (Urine)Reference range exampleChild (0 - 16y): 600–9,800 µmol/L; Adult ( > 16y): 2,700–13,000 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Threonine (Urine)Reference range exampleChild (0 - 16y): 250–1,000 µmol/L; Adult ( > 16y): 900–3,500 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Thyroglobulin (Tg)Reference range exampleInfant (0 - 1y), Female: 0.4–5.6 ng/mL; Infant (0 - 1y), Male: 0.5–5.6 ng/mLLinked diagnostic testsThyroglobulin (Tg) Concentration
- Thyroxine (Total T4)Reference range exampleAdult ( > 16y), Female: 6–12 µg/dL; Adult ( > 16y), Male: 5–12 µg/dLLinked diagnostic testsThyroxine (Total T4) Concentration
- Thyroxine Binding Globulin (TBG, Thyroid Binding Globulin, Blood)Reference range exampleInfant (0 - 1y), Female: 1.7–3.6 mg/dL; Infant (0 - 1y), Male: 1.6–3.5 mg/dLLinked diagnostic testsThyroxine Binding Globulin Concentration (TBG, Thyroid Binding Globulin
- Triiodothyronine (Total T3)Reference range exampleInfant (0 - 1y): 1.1–2.43 ng/mL; Adult ( > 16y): 1–2.1 ng/mLLinked diagnostic testsTriiodothyronine (Total T3) Concentration
- Tyrosine (Urine)Reference range exampleChild (0 - 16y): 300–850 µmol/L; Adult ( > 16y): 400–1,500 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Urine bilirubinReference range exampleAll: 0–0.02 mg/dLLinked diagnostic testsUrine bilirubin Concentration
- Urobilinogen (Urine)Reference range exampleAll: 0.1–1 mg/dLLinked diagnostic testsUrine Urobilinogen Concentration
- UroporphyrinReference range exampleAdult ( > 16y), Female: 100–270 nmol/L; Adult ( > 16y), Male: 100–540 nmol/LLinked diagnostic testsUrine Porphyrin Concentration
- Valine (Urine)Reference range exampleChild (0 - 16y): 200–400 µmol/L; Adult ( > 16y): 200–750 µmol/LLinked diagnostic testsUrine Amino Acid Concentration
- Vitamin B12 (VB12)Reference range exampleAdult ( > 16y): 130–670 pmol/LLinked diagnostic testsVitamin B12 (VB12) Concentration
- White Blood Cell (WBC)Reference range exampleAdult ( > 16y): 4.5–10.5 million/mL; Adult ( > 16y): 3.2–10 million/mLLinked diagnostic testsWhite Blood Cell (WBC) Count
Often decreased
24- Albumin (Blood)Reference range exampleAdult ( > 16y): 37–52 gm/dL; Infant (0 - 1y): 4.4–5.4 gm/dLLinked diagnostic testsBlood Albumin Concentration, Protein Electrophoresis (Blood
- Alpha-2-Globulin (Blood, Serum)Reference range exampleAll: 0.6–1 gm/dLLinked diagnostic testsProtein Electrophoresis (Blood, Serum Protein)
- AmylaseReference range exampleAdult ( > 16y): 25–125 units/LLinked diagnostic testsamylase concentration
- Apolipoprotein A (Apo A)Reference range exampleAdult ( > 16y), Female: 85–170 mg/dL; Adult ( > 16y), Male: 77–155 mg/dLLinked diagnostic testsApolipoprotein A Concentration
- Blood Urea NitrogenReference range exampleAdult ( > 16y): 6–18 mg/dL; Child (< 10y): 5–15 mg/dLLinked diagnostic testsBlood Urea Nitrogen Tests
- CholinesteraseReference range exampleAll: 6–19 U/mLLinked diagnostic testsCholinesterase (Serum Acetylcholinesterase, Pseudocholinesterase)
- Creatine Kinase (CK)Reference range exampleAdult ( > 16y), Female: 35–150 units/L; Adult ( > 16y), Male: 40–170 units/LLinked diagnostic testsCreatine Kinase Concentration
- Factor II (Prothrombin, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 80–120 %; Adult ( > 16y): 80–120 %Linked diagnostic testsCoagulation Factor Assay (Blood CLotting Factors, Coagulation Factor Assay (Blood Clotting Factors)
- Factor IX (Christmas Factor, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 60–140 %Linked diagnostic testsCoagulation Factor Assay (Blood Clotting Factors)
- Factor V (Labile Factor, Proaccelerin, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 50–150 %Linked diagnostic testsCoagulation Factor Assay (Blood Clotting Factors)
- Factor X (Stuart Prower Factor, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 45–155 %Linked diagnostic testsCoagulation Factor Assay (Blood Clotting Factors)
- Factor XI (Plasma Thromboplastin Antecedent, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 65–135 %Linked diagnostic testsCoagulation Factor Assay (Blood Clotting Factors)
- Factor XII (Hageman Factor, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 50–150 %Linked diagnostic testsCoagulation Factor Assay (Blood Clotting Factors)
- FibrinogenReference range exampleAdult ( > 16y): 150–400 mg/dLLinked diagnostic testsFibrinogen Concentration test
- Glucose (Blood)Reference range exampleInfant (0 - 1y): 3–6.1 mmol/L; Adult ( > 16y): 0–6.1 mmol/LLinked diagnostic testsfasting Blood Glucose Test, Glucose Tolerance Test (GTT
- haptoglobin (Hp)Reference range example45–200 mg/dLLinked diagnostic testshaptoglobin (Hp) concentration
- High Density Lipoprotein (HDL)Reference range exampleAdult ( > 16y), Female: 53–500 mg/dL; Adult ( > 16y), Male: 45–500 mg/dLLinked diagnostic testsHigh Density Lipoprotein (HDL) Concentration
- PlasminogenReference range exampleAdult ( > 16y), Female: 65–153 %; Adult ( > 16y), Male: 70–120 %Linked diagnostic testsPlasminogen Activity
- Potassium (K, Blood)AbbreviationKReference range exampleInfant (0 - 1y): 4.1–5.3 mEq/L; Child (0 - 16y): 3.4–4.7 mEq/LLinked diagnostic testsPotassium Concentration (K, Blood)
- Triiodothyronine (Free T3)Reference range example2.7–4.9 pg/mLLinked diagnostic testsTriiodothyronine (Free T3) Concentration
- Triiodothyronine Uptake PercentageReference range exampleAll: 25–38 %Linked diagnostic testsTriiodothyronine Uptake Test
- Uric Acid, BloodReference range exampleAdult ( > 16y), Female: 2.5–7 mg/dL; Adult ( > 16y), Male: 4–8 mg/dLLinked diagnostic testsBlood Uric Acid Concentration Test
- Urine SodiumReference range exampleChild (0 - 16y): 41–115 mmol/day; Adult ( > 16y): 40–220 mmol/dayLinked diagnostic testsUrine Sodium Quantitative (24hr)
- Urobilinogen (Stools)Reference range exampleAll: 50–300 mg/24hrsLinked diagnostic testsFecal Urobilinogen Concentration
Introduction / full article
Fulminant Hepatitis
Fulminant Hepatitis
A rare liver condition in which the onset is rapid. In fulminant hepatitis, liver failure occurs within 8 weeks from the onset of symptoms. Fulminant hepatitis usually affects younger individuals. Symptoms include liver failure, jaundice, hypertension, and change in the size of the liver. Treatment of fulminant hepatitis starts with intensive care; including airway maintenance, fluid management, monitoring for infection, proper nutrition, and monitoring the gastrointestinal tract for possible bleeds. The best way to combat fulminant hepatitis and prevent further damage is through a liver transplant.
Summary Reference
Treatment:
1. http://www.merck.com/mmpe/sec03/ch027/ch027b.html?qt=fulminant%20hepatitis&alt=sh#sec03-ch027-ch027b-463