Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States
Hepatitis E virus (HEV) infection in immunocompetent individuals is uncommon in the United States. We report a case of elderly man who presented with jaundice, cholestatic hepatitis, and subacute liver failure with fatal outcome. The patient was started on steroids based on ANA positivity. Liver bio...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-06-01
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| Series: | Human Pathology: Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214330017301748 |
| _version_ | 1817987803964768256 |
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| author | Marie L. Landry Saleem Kamili Dhanpat Jain |
| author_facet | Marie L. Landry Saleem Kamili Dhanpat Jain |
| author_sort | Marie L. Landry |
| collection | DOAJ |
| description | Hepatitis E virus (HEV) infection in immunocompetent individuals is uncommon in the United States. We report a case of elderly man who presented with jaundice, cholestatic hepatitis, and subacute liver failure with fatal outcome. The patient was started on steroids based on ANA positivity. Liver biopsy showed panlobular hepatitis with cholestasis. The histologic differential diagnosis included drug/toxic injury, biliary obstruction, and acute hepatitis C or hepatitis E. Drug/toxic injury was favored initially. However, subsequent serology was positive for anti-HEV IgM and IgG, and HEV RNA genotype 3 was detected in both serum and liver tissue. Awareness of autochthonous hepatitis E and its inclusion in the differential diagnosis is needed for early diagnosis and appropriate management. |
| first_indexed | 2024-04-14T00:26:36Z |
| format | Article |
| id | doaj.art-a05751d9e5db46cfbcf3f541669dfd5d |
| institution | Directory Open Access Journal |
| issn | 2214-3300 |
| language | English |
| last_indexed | 2024-04-14T00:26:36Z |
| publishDate | 2018-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Human Pathology: Case Reports |
| spelling | doaj.art-a05751d9e5db46cfbcf3f541669dfd5d2022-12-22T02:22:43ZengElsevierHuman Pathology: Case Reports2214-33002018-06-0112C687010.1016/j.ehpc.2018.02.007Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United StatesMarie L. Landry0Saleem Kamili1Dhanpat Jain2Departments of Laboratory Medicine and Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, United StatesDivision of Viral Hepatitis, National Center for HIV, Hepatitis, STD, TB Prevention, Centers for Disease Control and Prevention, Atlanta 30329, GA, United StatesDepartments of Pathology and Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, United StatesHepatitis E virus (HEV) infection in immunocompetent individuals is uncommon in the United States. We report a case of elderly man who presented with jaundice, cholestatic hepatitis, and subacute liver failure with fatal outcome. The patient was started on steroids based on ANA positivity. Liver biopsy showed panlobular hepatitis with cholestasis. The histologic differential diagnosis included drug/toxic injury, biliary obstruction, and acute hepatitis C or hepatitis E. Drug/toxic injury was favored initially. However, subsequent serology was positive for anti-HEV IgM and IgG, and HEV RNA genotype 3 was detected in both serum and liver tissue. Awareness of autochthonous hepatitis E and its inclusion in the differential diagnosis is needed for early diagnosis and appropriate management.http://www.sciencedirect.com/science/article/pii/S2214330017301748 |
| spellingShingle | Marie L. Landry Saleem Kamili Dhanpat Jain Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States Human Pathology: Case Reports |
| title | Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States |
| title_full | Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States |
| title_fullStr | Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States |
| title_full_unstemmed | Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States |
| title_short | Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States |
| title_sort | subacute liver failure due to autochthonous hepatitis e virus infection in an elderly man in the united states |
| url | http://www.sciencedirect.com/science/article/pii/S2214330017301748 |
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