Authors:
Ike Rahayu Widuri
;
Iswan Abbas Nusi
;
Poernomo Boedi Setiawan
;
Herry Purbayu
;
Titong Sugihartono
;
Ummi Maimunah
;
Ulfa Kholili
;
Budi Widodo
;
Muhammad Miftahussurur
;
Husin Thamrin
and
Amie Vidyani
Affiliation:
Universitas Airlangga, Indonesia
Keyword(s):
Acute liver failure, BCAA, HAV, HBV, INR
Abstract:
A 21-year-old male patient was admitted to the Emergency room of Dr. Soetomo General Hospital with a chief complaint of decrease in consciousness. Jaundice and mental status changes were found. Laboratory testing showed hyperbilirubinemia, progressive rise in serum alanine and aspirate aminotransferase levels, rise in prothrombin time and International Normalized Ratio (INR), positive IgM anti HAV. Diagnosis of this patient was acute liver failure due to acute hepatitis A. The patient was treated treatment with O2 nasal 3-4 lpm, a low-protein diet, fluid therapy including NaCl 0.9%, dextrose 10% and Branch Chain Amino Acids (BCAA), inj. ranitidine 2x1 amp, vitamin K 3x1 amp, FFP transfusion 10 cc/kg (first hour) followed by 1 cc/hour, lactulose syrup 4x30 cc, L-ornithine-L-aspartate 4 ampoule/PZ 100 cc for 4 hours. The patient was discharged in good condition. Three weeks later, the patient was monitored at the outpatient clinic, and jaundice was not found.