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Discussion

Fulminant hepatitis is characterised by

  • A.the absence of any symptoms at all
  • B.involvement of the kidneys rather than the liver
  • C.rapid, massive liver failure
  • D.a slow progression over several decades

Answer: C

Extensive hepatocyte death within days to weeks produces encephalopathy and coagulopathy, and mortality is high without transplantation. It is uncommon in every form of viral hepatitis but can follow any of them, and hepatitis E in pregnancy is a recognised setting.

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