encephalopathy. The etiology includes infectious, be caused by autoimmune hepatitis in 5% of cases metabolic diseases and toxic causes that may differ and an idiopathic form accounts for 40/50% of cases

risk factors for Fulminant Hepatic Failure (FHF) in (37.50%), and grade 2 in 25 (31.25%). Forty five children at a tertiary care hospital, Sukkur. (56.25%) patients expired. Patients with bilirubin Methodology: Retrospective review of patients 13.0±8.0 mg/dl vs 6.7±3.3 mg/dl recovered. ALT 1-14years, admitted with FHF from July 2007 to was lower in expired patients 467±381 IU/L vs June 2012, at Pediatric department of Ghulam 1834.3±1550.2 IU/L in recovered children. 45 Muhammad Mahar Medical College Hospital (52%) expired with INR of 4 or more. The risk Sukkur. Fulminant hepatic failure was defined as factors of FHF patients were grade 3 or 4 coagulopathy (PT > 20 sec or INR > 2) with or encephalopathy, high bilirubin, low ALT and INR without hepatic encephalopathy within 8 weeks of >4. the onset of symptoms. Conclusion: HAV and HBV were the most Results: Eighty patients with FHF (50 males and common etiologic agents of FHF. Children with 30 females) were admitted in our Pediatric FHF, high grade encephalopathy, high bilirubin, department. The most common cause of FHF was low ALT and INR >4 had poor outcome. (Rawal viral hepatitis in 62 (77.5%) and in 11 (13.75%) Med J 2013;38: 219-222). cases etiology was not established. Among 62