[When diagnostic imaging is misleading: a case of subacute liver failure]. / LE CAS CLINIQUE DU MOIS. Quand l'imagerie nous induit en erreur: à propos d'un cas d'insuffisance hépatique subaiguë.

We report the case of a 67 year old woman presenting with a mixed alteration of liver function tests. Despite normal results of tomodensitometry and positon emission tomography, a liver biopsy was performed due to the development of acute liver failure: it showed a diffuse infiltration of liver sinusoids by a breast adenocarcinoma, unfortunately fatal for the patient. The tumour infiltration was responsible for portal hypertension and hepatic perfusion disorders leading to liver failure.

[Hepatitis E: a Third World's hepatitis found in Belgium]. / L'hépatite E: une hépatite du Tiers-Monde présente en Belgique.

Hepatitis E virus is the second cause of acute viral hepatitis of oral-fecal origin in the world. This virus has a vast distribution throughout the world and manifests itself either in epidemic or endemic-sporadic form in many developing countries. Usually, the cases of HEV infection in industrialized countries are observed after a history of travel in an endemic area. However, an increasing number of cases have been attributed to a HEV zoonotic form transmitted by swine. HEV infection can lead to deadly fulminant hepatic failure in 1-4% in the common population, but the mortality incidence reaches 20% in case of third trimester pregnant women infection. The diagnosis of HEV infection can be made using serological tests but today, RT-PCR is considered as the gold standard test. Unfortunately, this technique is not widely available in Belgium yet. There is no treatment for HEV infection, only prophylactic measures as hygiene and sewage treatment can stop epidemics. Recently, a new vaccine, still in research phase, has showed promising outcomes.