@article {Poovorawan:March 2006:0272-4936:17,
	author = "Poovorawan, Yong",
	author = "Hutagalung, Yanee",
	author = "Chongsrisawat, Voranush",
	author = "Boudville, Irving",
	author = "Bock, Hans L.",
	title = "Dengue virus infection: a major cause of acute hepatic failure in Thai children",
	journal = "Annals of Tropical Paediatrics: International Child Health",
	volume = "26",
	year = "March 2006",
	abstract = "<I>Background:</I> Acute hepatic failure (AHF) can be caused by a variety of viruses, drugs, toxins and metabolic disorders.<P></P><I>Aims:</I> A prospective study was conducted to determine the aetiology and outcome of AHF in Thai children aged 1&#8211;15 years.<P></P><I>Methods:</I> All serum samples were tested for anti-HAV IgM, HBsAg, anti-HBc IgM, anti-HCV, anti-HEV IgM and anti-dengue IgG and IgM. Further individual investigations were done according to the clinical impression.<P></P><I>Results:</I> Forty subjects were enrolled from 14 centres during February 2000 to December 2001. Five cases were excluded owing to a lack of evidence of encephalopathy. The causes of AHF were dengue infection in 12 (34.3%), Wilson disease in 2 (5.7%), T-cell lymphoma in 2 (5.7%), ischaemic hepatitis in two (5.7%), haemophagocytic syndrome in one (2.8%), CMV in 2 (5.7%), Reye syndrome in one (2.8%) and unknown in 13 (37.1%) patients. The fatality rate was 68.6%. Eight of 24 (33.3%) deaths were caused by dengue infection.<P></P><I>Conclusions:</I> Improvements in sanitation and socio-economic status as well as the implementation of hepatitis B vaccine in the Extended Programme on Immunization (EPI) are likely to be the reasons for the observed absence of AHF caused by hepatitis A and B. The study showed that dengue infection, on the other hand, was a major cause of AHF in Thailand.",
	pages = "17-23(7)",
	url = "http://www.ingentaconnect.com/content/maney/atp/2006/00000026/00000001/art00002"
	doi = "doi:10.1179/146532806X90565"
}