Sword of Damocles: a hard blow from hepatitis A.

Introduction and Objectives: The global incidence of liver failure associated with hepatitis A virus infection is reported in 0.5% of all cases, among which the associated risk factors are age over 40 years and pre-existing liver disease, and about 40% of the cases require liver transplantation. Mat...

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Main Authors: Jerónimo D. Galván-Rodríguez, Karla G. Fonseca-Castillo, Yolanda G. Nuño-Curiel, Melina Chaires-Navarro, Óscar H. Murillo-Robledo, Juan J. Morales-Reyes, María L. Guzmán-Ramírez, Kevin J. Arellano-Arteaga
Format: Article
Language:English
Published: Elsevier 2024-02-01
Series:Annals of Hepatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1665268124002035
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author Jerónimo D. Galván-Rodríguez
Karla G. Fonseca-Castillo
Yolanda G. Nuño-Curiel
Melina Chaires-Navarro
Óscar H. Murillo-Robledo
Juan J. Morales-Reyes
María L. Guzmán-Ramírez
Kevin J. Arellano-Arteaga
author_facet Jerónimo D. Galván-Rodríguez
Karla G. Fonseca-Castillo
Yolanda G. Nuño-Curiel
Melina Chaires-Navarro
Óscar H. Murillo-Robledo
Juan J. Morales-Reyes
María L. Guzmán-Ramírez
Kevin J. Arellano-Arteaga
author_sort Jerónimo D. Galván-Rodríguez
collection DOAJ
description Introduction and Objectives: The global incidence of liver failure associated with hepatitis A virus infection is reported in 0.5% of all cases, among which the associated risk factors are age over 40 years and pre-existing liver disease, and about 40% of the cases require liver transplantation. Materials and Patients: A 29-year-old man, previously healthy and without any identified risk factors. One week prior to his admission, after eating shellfish, he presented intense colicky abdominal pain without radiation, nausea, vomiting, abundant non-steatorrhea, diarrheal stools, and unquantified fever.He went to a private clinic where unspecified medication was administered and an abdominal ultrasound was performed, where hepatomegaly was reported. Laboratory studies showed alteration in liver biochemistry integrating hepatocellular damage 10 times above the normal upper limit as well as prolongation of coagulation times. Three days after the onset of the symptoms, generalized jaundice, aggressiveness and drowsiness were added, for which he was referred to our hospital unit. Upon admission, he presented a stupor and was taken to invasive mechanical ventilation. Results: The approach was started, and results were reactive for IgM to hepatitis A virus and non-reactive for HIV, hepatitis B and C viruses. He remained intubated for five days and presented acute kidney injury that required hemodialysis and coagulopathy without presenting clinical data of bleeding; subsequently, he gradually presented clinical and laboratory improvement, and after 12 days of hospitalization, he was discharged home. Conclusions: In the approach to acute liver failure, it is important to consider infection by the hepatitis A virus, because, despite the fact that the incidence of infection in Mexico is 5%, not all of the Mexican population has access to the vaccination and is the only effective measure to prevent this disease.In the case of our patient, he did not present these risk factors and had a spontaneous recovery. Within the approach to fulminant hepatitis, it is important to consider infection by the hepatitis A virus, because even though the incidence in our country is 5%, not the entire Mexican population has access to vaccination.
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spelling doaj.art-3b86ea8908bb4521b9b072293187b8592024-03-06T05:26:00ZengElsevierAnnals of Hepatology1665-26812024-02-0129101409Sword of Damocles: a hard blow from hepatitis A.Jerónimo D. Galván-Rodríguez0Karla G. Fonseca-Castillo1Yolanda G. Nuño-Curiel2Melina Chaires-Navarro3Óscar H. Murillo-Robledo4Juan J. Morales-Reyes5María L. Guzmán-Ramírez6Kevin J. Arellano-Arteaga7Internal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraInternal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México, Programa de Especialidad en Medicina Interna. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraIntroduction and Objectives: The global incidence of liver failure associated with hepatitis A virus infection is reported in 0.5% of all cases, among which the associated risk factors are age over 40 years and pre-existing liver disease, and about 40% of the cases require liver transplantation. Materials and Patients: A 29-year-old man, previously healthy and without any identified risk factors. One week prior to his admission, after eating shellfish, he presented intense colicky abdominal pain without radiation, nausea, vomiting, abundant non-steatorrhea, diarrheal stools, and unquantified fever.He went to a private clinic where unspecified medication was administered and an abdominal ultrasound was performed, where hepatomegaly was reported. Laboratory studies showed alteration in liver biochemistry integrating hepatocellular damage 10 times above the normal upper limit as well as prolongation of coagulation times. Three days after the onset of the symptoms, generalized jaundice, aggressiveness and drowsiness were added, for which he was referred to our hospital unit. Upon admission, he presented a stupor and was taken to invasive mechanical ventilation. Results: The approach was started, and results were reactive for IgM to hepatitis A virus and non-reactive for HIV, hepatitis B and C viruses. He remained intubated for five days and presented acute kidney injury that required hemodialysis and coagulopathy without presenting clinical data of bleeding; subsequently, he gradually presented clinical and laboratory improvement, and after 12 days of hospitalization, he was discharged home. Conclusions: In the approach to acute liver failure, it is important to consider infection by the hepatitis A virus, because, despite the fact that the incidence of infection in Mexico is 5%, not all of the Mexican population has access to the vaccination and is the only effective measure to prevent this disease.In the case of our patient, he did not present these risk factors and had a spontaneous recovery. Within the approach to fulminant hepatitis, it is important to consider infection by the hepatitis A virus, because even though the incidence in our country is 5%, not the entire Mexican population has access to vaccination.http://www.sciencedirect.com/science/article/pii/S1665268124002035
spellingShingle Jerónimo D. Galván-Rodríguez
Karla G. Fonseca-Castillo
Yolanda G. Nuño-Curiel
Melina Chaires-Navarro
Óscar H. Murillo-Robledo
Juan J. Morales-Reyes
María L. Guzmán-Ramírez
Kevin J. Arellano-Arteaga
Sword of Damocles: a hard blow from hepatitis A.
Annals of Hepatology
title Sword of Damocles: a hard blow from hepatitis A.
title_full Sword of Damocles: a hard blow from hepatitis A.
title_fullStr Sword of Damocles: a hard blow from hepatitis A.
title_full_unstemmed Sword of Damocles: a hard blow from hepatitis A.
title_short Sword of Damocles: a hard blow from hepatitis A.
title_sort sword of damocles a hard blow from hepatitis a
url http://www.sciencedirect.com/science/article/pii/S1665268124002035
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