Functioning Liver Mass in Uncomplicated and Fulminant Acute Hepatitis

The galactose elimination capacity and the plasma clearance of phenazone were investigated in 24 patients with uncomplicated acute hepatitis and in 8 patients who survived and in 26 who died of fulminant hepatitis. The galactose elimination capacity was 52% of the normal mean value on admission to the hospital in uncomplicated hepatitis, 47% in patients who survived fulminant hepatitis, and 22% in the fatal cases, while the plasma clearance of phenazone was 43%, 22%, and 10%, respectively. Both quantitative liver function tests showed rapid improvement in most cases of uncomplicated acute hepatitis and in the patients who survived fulminant hepatitis. They did not improve in the fatal cases of fulminant hepatitis, among whom the patients with the lowest initial values died first. Both the galactose elimination capacity and the plasma clearance of phenazone were significantly higher in survivors than in non-survivors of fulminant hepatitis. The results indicate that the loss of functioning liver cell mass is about 60-70% in the acute stage of uncomplicated hepatitis and 80-85% in patients who survive fulminant hepatitis, whereas patients who die of fulminant hepatitis have nearly total loss of functioning liver cell mass.