RESUMEN
INTRODUCTION: The causes of diaphragmatic paresis are manifold. An association between neuralgic amyotrophy (NA) and hepatitis E virus (HEV) infection has been reported. We wondered about the prevalence of diaphragmatic disfunction and hepatitis E infection in our clinic. METHODS: From July 1st, 2020 to August 31st, 2023, patients presenting with diaphragmatic dysfunction and simultaneous clinical symptoms of an acute NA, or a history of NA, as well as patients with previously unexplained diaphragmatic dysfunction were examined for HEV infection. RESULTS: By August 31st, 2023, 13 patients with diaphragmatic dysfunction and HEV infection were diagnosed (4 women, 9 men). Mean age was 59 ± 10 years. Liver values were normal in all patients. The median latency to diagnosis was five months (range: 1-48 months); nine patients, 4 of them with typical symptoms of NA, presented with acute onset three patients showed bilateral diaphragmatic dysfunction. All patients had a positive IgG immunoblot. Seven patients, three with NA, had an elevated hepatitis E IgM titer and six of them also a positive IgM immunoblot. In all cases, O2C hepatitis genotype 3 was identified. In eight cases, all those with a high IgG titer >125, the O2 genotype 1 was also detected. CONCLUSION: NA that shows involvement of the phrenic nerve resulting in diaphragmatic dysfunction and dyspnoea, may be associated with HEV infection. The observation of 13 patients with diaphragmatic dysfunctions and HEV infection within a period of three years indicates a high number of undetected HEV-associated diaphragmatic dysfunction in the population, especially in the absence of NA symptoms. Therefore, even in diaphragmatic dysfunction without NA symptoms and causative damaging event, HEV infection should be considered, as it may represent a subform of NA with only phrenic nerve involvement. Therapy of HEV-associated diaphragmatic dysfunction in the acute phase is an open question. In view of the poor prognosis for recovery, antiviral therapy should be discussed. However, no relevant data are currently available.
Asunto(s)
Hepatitis E , Parálisis Respiratoria , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuritis del Plexo Braquial/diagnóstico , Neuritis del Plexo Braquial/fisiopatología , Neuritis del Plexo Braquial/etiología , Neuritis del Plexo Braquial/virología , Diafragma/fisiopatología , Hepatitis E/complicaciones , Hepatitis E/diagnóstico , Hepatitis E/fisiopatología , Parálisis Respiratoria/etiología , Parálisis Respiratoria/fisiopatología , Parálisis Respiratoria/diagnóstico , Parálisis Respiratoria/virologíaRESUMEN
Acute viral hepatitis has been associated with several extrahepatic complications. Fulminant liver failure secondary to acute viral hepatitis may be complicated by acute pancreatitis. However, in the setting of benign viral hepatitis, in the absence of liver failure, association of pancreatitis is uncommon, that too in an otherwise immunocompetent individual. The exact mechanism of hepatitis-related pancreatitis remains elusive. Proposed mechanisms include immune-mediated injury against infected pancreatic acinar cells, oedema of the ampulla of Vater and release of lysosomal enzymes from the liver. A high index of clinical suspicion is needed in any case of viral hepatitis with severe abdominal pain to recognise acute pancreatitis as a possible complication, which may increase both morbidity and mortality if unrecognised. Herein, we report a case of a young man presenting with acute viral hepatitis due to hepatitis E infection, complicated by acute pancreatitis.
Asunto(s)
Enfermedad Aguda , Diagnóstico Diferencial , Hepatitis E/complicaciones , Hepatitis E/diagnóstico , Pancreatitis , Dolor Abdominal/etiología , Adolescente , Células Epiteliales , Hepatitis E/fisiopatología , Humanos , India , Masculino , Pancreatitis/complicaciones , Pancreatitis/diagnóstico , Tomografía Computarizada por Rayos X , Calidad del Agua/normasRESUMEN
Hepatitis E virus (HEV) infection has become a global concern with high mortality rates among pregnant women, especially those in their third trimester of pregnancy. Estrogen plays an important role in mediating the body, regulating physiological and pathological processes. Estrogen is activated by binding to estrogen receptors (ERs) and mediates rapid signaling events by pathways that involve transmembrane ERs. Our previous study had confirmed that high estrogen levels during pregnancy are associated with high HEV titers. However, the association between HEV infection and estrogen signaling pathways remains unclear. In the present study, the regulation of estrogen signaling pathways by HEV infection was evaluated. Results demonstrated that HEV infection significantly inhibits the cAMP-PKA-CREB and PI3K-AKT-mTOR signaling pathways, but is independent of the Ras-Raf-MEK-ERK signaling pathway. In summary, the increasing estrogen levels and highly activated ERα during pregnancy aggravates HEV replication. The exacerbation of HEV replication, in turn, inhibits ERα expression and suppresses both cAMP-PKA-CREB and PI3K-AKT-mTOR signaling pathways.
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Proteína de Unión a Elemento de Respuesta al AMP Cíclico/antagonistas & inhibidores , Estrógenos/metabolismo , Virus de la Hepatitis E/patogenicidad , Hepatitis E/fisiopatología , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/antagonistas & inhibidores , Transducción de Señal , Serina-Treonina Quinasas TOR/antagonistas & inhibidores , Células A549 , Estrógenos/genética , Femenino , Humanos , Embarazo , Proteínas Proto-Oncogénicas c-akt/metabolismoRESUMEN
Extrahepatic disorders are recorded with hepatitis E virus (HEV) infection. The impact of HEV infection on the male reproductive system is a query. In this study, we retrospectively analyzed semen from infertile men and prospectively examined the semen from acute hepatitis E patients (AHE) for HEV markers. HEV RNA and HEV Ag were not detectable in the semen of infertile men nor the semen of AHE patients. Although HEV markers were detectable in the urine of patients infected with HEV-1, these markers were absent in their semen. There is no significant difference in the level of reproductive hormones between AHE patients and healthy controls. Semen analysis of AHE patients did not show a notable abnormality and there was no significant difference in the semen quality and sperm characteristics between AHE and healthy controls.
Asunto(s)
Genitales Masculinos/fisiología , Virus de la Hepatitis E/inmunología , Virus de la Hepatitis E/aislamiento & purificación , Hepatitis E/fisiopatología , Hepatitis E/virología , Infertilidad Masculina/virología , Adulto , Biomarcadores/análisis , Biomarcadores/orina , Genitales Masculinos/virología , Hormonas Esteroides Gonadales/sangre , Anticuerpos Antihepatitis/sangre , Antígenos de la Hepatitis/análisis , Antígenos de la Hepatitis/orina , Virus de la Hepatitis E/genética , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Infertilidad Masculina/fisiopatología , Masculino , Persona de Mediana Edad , ARN Viral/análisis , ARN Viral/orina , Estudios Retrospectivos , Semen/virología , Orina/virología , Adulto JovenRESUMEN
BACKGROUND: Hepatitis E virus (HEV) generally causes self-limiting viral hepatitis. However, in pregnant women, HEV infection can be severe and has been associated with up to 30% mortality in the third trimester. Additionally, HEV infection in pregnancy is also associated with high rates of preterm labor and vertical transmission. MAIN BODY: HEV is now recognized as a global health problem in both developing and industrialized countries. HEV can be transmitted via the fecal-oral route, zoonotic route, and blood transfusion route. An altered immune status, hormonal levels, and viral factors may be related to the severity of the disease. Currently, no established treatment is available for HEV in pregnant women. A Chinese vaccine has been demonstrated to be protective against HEV in the general population and seems to be safe in pregnancy; however, its safety and efficacy in a large population of pregnant women remain to be determined. CONCLUSION: This review summarizes the current knowledge about HEV infection during pregnancy and focuses on the epidemiology, clinical manifestations, mechanisms underlying severe liver injury, and management and prevention of HEV infection during pregnancy. Considering that HEV infection during pregnancy may result in poor outcomes, screening for and monitoring HEV infection early in pregnancy should be taken into account. In addition, a better understanding of the pathogenesis will help to develop potential treatment strategies targeting HEV infection in pregnancy.
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Hepatitis E/epidemiología , Hepatitis E/fisiopatología , Hígado/patología , Complicaciones Infecciosas del Embarazo/virología , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Hígado/virología , Trabajo de Parto Prematuro/virología , Embarazo , Complicaciones Infecciosas del Embarazo/fisiopatologíaRESUMEN
Hepatitis E Virus (HEV) is emerging as the primary cause of acute viral hepatitis in humans. The virus is commonly transmitted by the fecal-oral route via contaminated water in endemic regions or through the consumption of inadequately cooked swine products or game meats in industrialized regions. HEV genotypes 1 and 2 are predominantly associated with waterborne transmission in developing countries, whereas HEV3 and HEV4 are mainly zoonotically transmitted in industrialized countries. Seroprevalence in populations determined by detecting anti-HEV antibodies and serum HEV RNA is commonly used to analyze the presence of HEV. Although HEV RNA-based detection is now standardized, there is a lack of agreement between the assaying methods used for gathering seroprevalence data. Since 2004, HEV has been considered as a transmissible infectious agent through blood transfusion. Recent seroprevalence studies in European countries indicate an underestimated risk for blood transfusion and hence warrant testing the blood supply. HEV infection is usually self-limiting and spontaneously cleared. However, in about 60% of recipients of solid organ transplants, HEV progresses to chronic hepatitis. Immunosuppressive drugs such as tacrolimus are a major cause of chronic hepatitis and reducing its dosage results in viral clearance in about 30% of patients. In hemodialysis patients, the parenteral route is implicated as an important mechanism of transmission. In this review, we explore the clinical and epidemiological characteristics of various HEV genotypes in blood donors, hemodialysis patients, and transplant recipients.
Asunto(s)
Transfusión Sanguínea/métodos , Hepatitis E/complicaciones , Trasplante de Órganos/tendencias , Diálisis Renal/métodos , Transfusión Sanguínea/tendencias , Hepatitis E/fisiopatología , Virus de la Hepatitis E/patogenicidad , Humanos , Trasplante de Órganos/métodos , Diálisis Renal/tendenciasRESUMEN
Hepatitis E is an enteric disease highly prevalent in the developing countries. The basis for high mortality among pregnant hepatitis E patients remains unclear. Importantly, a large proportion of infected pregnant women present with subclinical infection as well. In order to understand the possible mechanisms influencing clinical presentation of hepatitis E in pregnant women, we explored a system biology approach. For this, PBMCs from various categories were subjected to RNAseq analysis. These included non-pregnant (NPR, acute and convalescent phases) and pregnant (PR, 2nd and 3rd trimesters, acute phase and subclinical HEV infections) patients and corresponding healthy controls. The current study deals with immune response genes. In contrast to exclusive up-regulation of nonspecific, early immune response transcripts in the NPR patients, the PR patients exhibited broader and heightened expression of genes associated with innate as well as adaptive T and B cell responses. The study identified for the first time (1) inverse relationship of immunoglobulin (Ig) genes overexpression and (2) association of differential expression of S100 series genes with disease presentation. The data suggests possible involvement of TLR4 and NOD1 in pregnant patients and alpha defensins in all patient categories suggesting a role in protection. Induction of IFNγ gene was not detected during the acute phase irrespective of pregnancy. Association of response to vitamin D, transcripts related to NK/NKT and regulatory T cells during subclinical infection are noteworthy. The data obtained here could be correlated with several studies reported earlier in hepatitis E patients suggesting utility of PBMCs as an alternate specimen. The extensive, informative data provided here for the first time should form basis for future studies that will help in understanding pathogenesis of fulminant hepatitis E.
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Perfilación de la Expresión Génica , Regulación de la Expresión Génica/inmunología , Hepatitis E/genética , Hepatitis E/inmunología , Leucocitos Mononucleares/metabolismo , Complicaciones del Embarazo/virología , Trimestres del Embarazo/genética , Adulto , Femenino , Ontología de Genes , Hepatitis E/fisiopatología , Humanos , Embarazo , Complicaciones del Embarazo/genética , Complicaciones del Embarazo/inmunología , Trimestres del Embarazo/inmunología , Adulto JovenAsunto(s)
Virus de la Hepatitis A Humana/fisiología , Hepatitis A , Virus de la Hepatitis E/fisiología , Hepatitis E , Transmisión de Enfermedad Infecciosa , Salud Global , Hepatitis A/epidemiología , Hepatitis A/fisiopatología , Hepatitis A/terapia , Hepatitis A/transmisión , Virus de la Hepatitis A Humana/aislamiento & purificación , Hepatitis E/epidemiología , Hepatitis E/fisiopatología , Hepatitis E/terapia , Hepatitis E/transmisión , Virus de la Hepatitis E/aislamiento & purificación , Humanos , Servicios Preventivos de Salud/métodosRESUMEN
Some European countries recently reported an increase in hepatitis E virus genotype 3 (HEV-3) of the subtype 3c. No link between HEV-3 subtypes and severity is established to date. Here, we report that patients infected with HEV-3c were at lower risk of hospitalisation, compared to those infected with HEV-3f, the other main subtype circulating in Belgium.
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Virus de la Hepatitis E/genética , Virus de la Hepatitis E/aislamiento & purificación , Hepatitis E/epidemiología , Hepatitis E/genética , Mortalidad Hospitalaria , Sistema de Registros , Adulto , Factores de Edad , Anciano , Animales , Bélgica/epidemiología , Intervalos de Confianza , Femenino , Genotipo , Hepatitis E/fisiopatología , Virus de la Hepatitis E/clasificación , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Filogenia , Prevalencia , Estudios Retrospectivos , Medición de Riesgo , Factores Sexuales , Tasa de Supervivencia , Porcinos , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/virologíaRESUMEN
Hepatitis E virus (HEV) can lead to high mortality during pregnancy. This study was to investigate the adverse pregnancy outcomes caused by different HEV genotypes and their prevention by HEV 239 vaccine in rabbits. Forty-two female rabbits were randomly and equally divided into 7 groups (A-G). HEV 239 vaccine and a placebo were administered to groups E (10 µg×2), F (5 µg×2) and G (1 mL of PBS×2) before copulation. After pregnancy, 1 mL of 1.5×106 copies/mL rabbit HEV3 was inoculated to groups A, E, F and G, swine HEV4/human HEV3 to groups B/C, and group D was a negative control. Anti-HEV antibody, HEV RNA, and alanine aminotransferase (ALT)/aspartate aminotransferase (AST) levels were monitored. Pregnant rabbits infected by HEV manifested HEV infection symptoms including fecal virus shedding, ALT/AST elevation, and histopathological changes, and adverse pregnancy outcomes. Immunized pregnant rabbits in groups E and F showed no HEV infection symptoms and adverse outcomes. The newborn rabbits delivered by pregnant rabbits with/without immunization showed without/with HEV infection symptoms. This study demonstrated that multiple genotypes of HEV infection can cause adverse outcomes and HEV 239 vaccine can prevent HEV-related adverse outcomes in pregnant rabbits.
Asunto(s)
Virus de la Hepatitis E/fisiología , Hepatitis E/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Resultado del Embarazo , Vacunas contra Hepatitis Viral/administración & dosificación , Animales , Modelos Animales de Enfermedad , Femenino , Anticuerpos Antihepatitis/inmunología , Hepatitis E/inmunología , Hepatitis E/fisiopatología , Hepatitis E/virología , Virus de la Hepatitis E/clasificación , Virus de la Hepatitis E/genética , Virus de la Hepatitis E/inmunología , Humanos , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/inmunología , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/virología , Conejos , Esparcimiento de VirusRESUMEN
Hepatitis E virus has two distinct clinical and epidemiological patterns based on the varying genotypes. Genotypes 3 and 4 cause widespread, sporadic infection in high-income countries and are emerging as the most common type of viral hepatitis in much of Europe. These infections carry significant morbidity and mortality in the growing numbers of immunosuppressed patients or in patients with established liver disease. Furthermore the growing extra-hepatic associations of the virus, including neurological and kidney injury, suggest that it may have been misnamed as a 'hepatitis' virus. This review explores current understanding of the epidemiology, virology and clinical presentations of hepatitis E infection and identifies vulnerable patient groups, who are at serious risk from infection. Guidance is offered regarding the diagnosis, treatment and prevention of this growing public health hazard.
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Hepatitis E/epidemiología , Hepatitis E/fisiopatología , Animales , Seguridad de la Sangre , Europa (Continente)/epidemiología , Genotipo , Salud Global , Hepatitis E/prevención & control , Hepatitis E/virología , Huésped Inmunocomprometido , Inmunoglobulina G/metabolismo , ARN Viral , ZoonosisRESUMEN
Hepatitis E virus (HEV) is an underdiagnosed pathogen with approximately 20 million infections each year and currently the most common cause of acute viral hepatitis. HEV was long considered to be confined to developing countries but there is increasing evidence that it is also a medical problem in the Western world. HEV that infects humans belongs to the Orthohepevirus A species of the Hepeviridae family. Novel HEV-like viruses have been observed in a variety of animals and some have been shown to be able to cross the species barrier, causing infection in humans. Several cell culture models for HEV have been established in the past years, but their efficiency is usually relatively low. With the circulation of this virus and related viruses in a variety of species, several different animal models have been developed. In this review, we give an overview of these animal models, indicate their main characteristics, and highlight how they may contribute to our understanding of the basic aspects of the viral life cycle and cross-species infection, the study of pathogenesis, and the evaluation of novel preventative and therapeutic strategies.
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Modelos Animales de Enfermedad , Virus de la Hepatitis E/crecimiento & desarrollo , Hepatitis E/patología , Animales , Hepatitis E/fisiopatología , Virus de la Hepatitis E/patogenicidadAsunto(s)
Virus de la Hepatitis E , Hepatitis E , Inmunosupresores/uso terapéutico , Insuficiencia Multiorgánica/cirugía , Trasplante de Órganos , Ribavirina , Sofosbuvir , Adulto , Antivirales/administración & dosificación , Antivirales/efectos adversos , Farmacorresistencia Viral/genética , Quimioterapia Combinada/métodos , Hepatitis E/diagnóstico , Hepatitis E/tratamiento farmacológico , Hepatitis E/fisiopatología , Virus de la Hepatitis E/genética , Virus de la Hepatitis E/aislamiento & purificación , Humanos , Masculino , Insuficiencia Multiorgánica/etiología , Trasplante de Órganos/efectos adversos , Trasplante de Órganos/métodos , Ribavirina/administración & dosificación , Ribavirina/efectos adversos , Sofosbuvir/administración & dosificación , Sofosbuvir/efectos adversos , Insuficiencia del TratamientoRESUMEN
Although neuralgic amyotrophy (NA) has occasionally been reported to be associated with reactivated herpes zoster, their associated risk remains unknown. The aim of this study was to assess the risk of developing NA following preceding herpes zoster. The authors used the National Health Insurance Research Database of Taiwan to select 41,548 patients with newly diagnosed herpes zoster during the period 2000 to 2010 and randomly extracted 166,192 matched control subjects. All participants in the study and control groups were followed for 3 months after the diagnosis to identify those who developed NA. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of NA. Twenty-one subjects from the group with herpes zoster (0.05%) developed NA over the 3-month period and 46 from the group without herpes zoster (0.03%). The patients with herpes zoster had a higher risk of developing NA (adjusted hazard ratio = 1.408, 95% confidence interval = 1.013-2.319, P = 0.030). In the patients with herpes zoster, female sex, age ≥ 65, hepatitis E virus (HEV), and having had a recent infectious event including pneumonia and influenza were risk factors for developing NA (adjusted HR 2.746, 1.998, 2.735, 2.016, and 1.718, respectively, all P < 0.05). Patients with herpes zoster attack have a higher risk of developing NA over a 3-month period after diagnosis, especially those who are female, age ≥ 65, HEV, or have experienced a recent infectious event or pneumonia and influenza.
Asunto(s)
Neuritis del Plexo Braquial/diagnóstico , Herpes Zóster/diagnóstico , Herpesvirus Humano 3/patogenicidad , Adolescente , Adulto , Factores de Edad , Anciano , Neuritis del Plexo Braquial/complicaciones , Neuritis del Plexo Braquial/fisiopatología , Neuritis del Plexo Braquial/virología , Estudios de Casos y Controles , Bases de Datos Factuales , Femenino , Hepatitis E/diagnóstico , Hepatitis E/fisiopatología , Hepatitis E/virología , Herpes Zóster/complicaciones , Herpes Zóster/fisiopatología , Herpes Zóster/virología , Herpesvirus Humano 3/fisiología , Humanos , Gripe Humana/diagnóstico , Gripe Humana/fisiopatología , Gripe Humana/virología , Masculino , Persona de Mediana Edad , Neumonía/diagnóstico , Neumonía/fisiopatología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , TaiwánRESUMEN
When the evaluation of newly elevated liver enzymes is unrevealing, a common diagnosis of exclusion is drug-induced liver injury. A 39-year-old active duty service member who presented with jaundice after returning from a mission in Thailand was found to have an acute hepatitis and developing acute liver failure. He was ultimately diagnosed with acute hepatitis E, but his diagnosis was initially confounded by multiple exposures to supplements known to cause drug-induced liver injury. This case illustrates the importance of broadened serologic testing in patients with acute liver injury returning from countries endemic with hepatitis E and also highlights the challenges in diagnosis of acute hepatitis E with currently available testing.
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Hepatitis E/diagnóstico , Ictericia/etiología , Adulto , Hepatitis E/complicaciones , Hepatitis E/fisiopatología , Virus de la Hepatitis E/patogenicidad , Humanos , Ictericia/diagnóstico , Ictericia/fisiopatología , Fallo Hepático/etiología , Fallo Hepático/fisiopatología , Masculino , Personal Militar , Taiwán , ViajeRESUMEN
Hepatitis E virus (HEV) infection is an important public health problem. HEV infection has been identified as a major cause of enterically transmitted acute sporadic hepatitis in India especially in adult age group. India is hyperendemic for HEV, with the disease presenting both as outbreaks and as cases of acute sporadic viral hepatitis. Most of these outbreaks can be traced to contamination of drinking water supplies with human fecal matter. The last decade has witnessed tremendous change in our understanding of the virus in its epidemiology, clinical features, diagnostic approaches, treatment options and the need for vaccination. With the identification of culture systems for HEV and development of animal models for its replication, knowledge regarding its replication and pathogenesis has evolved. This review attempts to discuss the nuances in our understanding of this virus, its pathogenesis and diagnosis, especially with reference to the Indian scenario.
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Virus de la Hepatitis E/aislamiento & purificación , Hepatitis E/epidemiología , Animales , Manejo de la Enfermedad , Modelos Animales de Enfermedad , Brotes de Enfermedades , Enfermedades Endémicas , Enfermedades Transmitidas por los Alimentos/virología , Hepatitis E/diagnóstico , Hepatitis E/fisiopatología , Hepatitis E/terapia , Humanos , India/epidemiologíaRESUMEN
Hepatitis E virus is the etiological agent for Hepatitis E infection, which is congruent to Hepatitis A infection. The clinical spectrum of the disease range from asymptomatic self-limiting disease which requires no treatment to life threatening fulminant liver disease in pregnancy, G6PD deficient and post-liver transplant patients, which necessitate urgent treatment. Similarly we are reporting a case of a 28 year old male with no previous known comorbids, who presented in emergency department with low grade fever, yellow discolouration of eyes and upper abdominal pain for last 5-6 days. We affirmed the diagnosis of acute viral hepatitis E with G6PD deficiency. This case had a different prospect of HEV infection and its coexistence with G6PD deficiency, which lead to investigations, management and avoidance of complications of the disease.
Asunto(s)
Deficiencia de Glucosafosfato Deshidrogenasa , Hemólisis , Virus de la Hepatitis E , Hepatitis E , Insuficiencia Renal , Adulto , Anticuerpos Antivirales/sangre , Transfusión Sanguínea/métodos , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Hepatitis E/sangre , Hepatitis E/complicaciones , Hepatitis E/fisiopatología , Hepatitis E/terapia , Virus de la Hepatitis E/inmunología , Virus de la Hepatitis E/aislamiento & purificación , Humanos , Masculino , Diálisis Renal/métodos , Insuficiencia Renal/diagnóstico , Insuficiencia Renal/etiología , Insuficiencia Renal/fisiopatología , Insuficiencia Renal/terapia , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Hepatitis E virus (HEV) is gaining recognition as an important but under-recognized pathogen, particularly in immunocompromised individuals. It should be considered as a potential differential diagnosis in such patients presenting with acute hepatitis. We report a case of a kidney-pancreas transplant recipient who developed acute liver dysfunction; this was found to be due to HEV infection acquired through consumption of undercooked pork. His immunosuppression was cautiously reduced, and his liver biochemistry and viral PCR gradually normalized without the need for additional antiviral therapy.â©.
Asunto(s)
Hepatitis E/diagnóstico , Hepatitis E/terapia , Trasplante de Riñón , Trasplante de Páncreas , Enfermedad Aguda , Hepatitis E/fisiopatología , Humanos , Huésped Inmunocomprometido , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana EdadRESUMEN
Acute hepatitis E virus infections occurred during the third trimester in 2 pregnant women in France who sought treatment with nonspecific symptoms or asymptomatic elevation of liver enzymes. Infection cleared quickly in both women. We detected no hepatitis E RNA in 1 newborn's feces at 3 weeks of age.