RESUMEN
Hemophagocytic lymphohistiocytosis syndrome (HLH) is a rare hyperinflammatory disorder linked to acute pancreatitis. While there are only a few case reports available on this particular association, we would like to share the case of a 60-year-old man who experienced acute-onset abdominal pain typical of pancreatitis. Three days after admission, he developed fever, pancytopenia, hypertriglyceridemia, and hyperferritinemia. A bone marrow biopsy performed for evaluation of fever revealed hemophagocytosis. Initiation of treatment for HLH showed dramatic improvement. It is important to note that while HLH may be rarely associated with pancreatitis, early diagnosis and treatment is critical and can be life-saving.
RESUMEN
Acute viral hepatitis E (HEV) is the most common form of acute viral hepatitis in India. It is associated with self-limiting disease in most cases. However, the chronic form of HEV is also being increasingly recognized. Other viral infections like the hepatitis A virus (HAV) have been implicated in inciting autoimmune hepatitis. HEV infection has been associated with the formation of circulating liver-directed autoantibodies, however autoimmune liver disease following acute HEV infection has been rarely reported. Here we present a case of a 72-year-old diabetic lady who presented to us with an asymptomatic rise of liver enzymes. Investigations suggested metabolic dysfunction associated with steatotic liver disease. After three months of the diagnosis, she developed acute-on-chronic liver failure and her anti-HEV came out positive. She was managed accordingly. Afterwards patient had persistent high liver enzymes, so she underwent a liver biopsy. Her liver biopsy was compatible with autoimmune hepatitis.