Pediatric acute viral hepatitis with atypical variants: Clinical dilemmas and natural history

Table 1 Differentiation between Ascitic form of acute viral hepatitis, decompensated chronic liver disease, acute on chronic liver failure and late onset hepatic failure

	Ascitic form of AVH[26]	Decompensated CLD[29]	ACLF[31]	LOHF[42]
Prodrome	Yes	No	Yes/No	Yes
Jaundice to ascites interval	Variable	Within first 3-4 wk	Within first 3-4 wk	After 3-4 wk
Encephalopathy	No	43%	66%	51%
Coagulopathy	No	Yes	Yes	Yes
Variceal bleeding	No	16%	14%	No
Growth failure	No	Yes	28%	No
Stigmata of liver disease	No	Yes	Yes	No
Acute insult	Yes	No	Yes	Yes
Nature of ascites	Rapidly resolving and Non-recurrent	Intractable and recurrent	Intractable and recurrent	Intractable and recurrent
Liver span	Enlarged	Enlarged or shrunken	Enlarged or shrunken	Mostly shrunken
Liver nodularity	No	Yes	Yes	No
Liver margins	Regular	Irregular	Irregular	Regular
Portal vein	Normal	May be dilated	May be dilated	Normal
Large Esophageal varices	No	May be present	May be present	No
Gastric varices	No	Yes	Yes	No
Survival with native liver	Yes	66%	61%	25%

AVH: Acute viral hepatitis; CLD: Chronic liver disease; ACLF: Acute on chronic liver failure; LOHF: Late onset hepatic failure.