Late-Relapsing Hepatitis after Yellow Fever
One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-02-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/12/2/222 |
| _version_ | 1811310250415882240 |
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| author | Izabela Maurício Rezende Leonardo Soares Pereira Jordana Rodrigues Barbosa Fradico Marcelo Antônio Pascoal Xavier Pedro Augusto Alves Ana Carolina Campi-Azevedo Elaine Speziali Lívia Zignago Moreira dos Santos Natalia Soares Albuquerque Indiara Penido Tayrine Araujo Santos Ana Paula Dinis Ano Bom Andrea Marques Vieira da Silva Camilla Bayma Fernandes Carlos Eduardo Calzavara Erna Geessien Kroon Olindo Assis Martins-Filho Andréa Teixeira-Carvalho Betânia Paiva Drumond |
| author_facet | Izabela Maurício Rezende Leonardo Soares Pereira Jordana Rodrigues Barbosa Fradico Marcelo Antônio Pascoal Xavier Pedro Augusto Alves Ana Carolina Campi-Azevedo Elaine Speziali Lívia Zignago Moreira dos Santos Natalia Soares Albuquerque Indiara Penido Tayrine Araujo Santos Ana Paula Dinis Ano Bom Andrea Marques Vieira da Silva Camilla Bayma Fernandes Carlos Eduardo Calzavara Erna Geessien Kroon Olindo Assis Martins-Filho Andréa Teixeira-Carvalho Betânia Paiva Drumond |
| author_sort | Izabela Maurício Rezende |
| collection | DOAJ |
| description | One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepatitis, inflammatory or metabolic liver disease, and new infections caused by hepatotropic agents. Anti-YFV IgM, IgG and neutralizing antibodies were detected in different times, but no viremia. A liver biopsy was collected three months after YF onset and tested positive for YFV antigens and wild-type YFV-RNA (364 RNA-copies/gram/liver). Transaminases and bilirubin levels remained elevated for five months, and the arresting of symptoms persisted for six months after the acute YF onset. Several serum chemokines, cytokines, and growth factors were measured. A similar immune response profile was observed in the earlier phases of the disease, followed by more pronounced changes in the later stages, when transaminases levels returned to normal. The results indicated viral persistence in the liver and continual liver cell damage three months after YF onset and reinforced the need for extended follow-ups of YF patients. Further studies to investigate the role of possible viral persistence and the immune response causing relapsing hepatitis following YF are also necessary. |
| first_indexed | 2024-04-13T09:55:51Z |
| format | Article |
| id | doaj.art-a1bc103ea1e54e329b2ac58301826e5a |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-04-13T09:55:51Z |
| publishDate | 2020-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-a1bc103ea1e54e329b2ac58301826e5a2022-12-22T02:51:25ZengMDPI AGViruses1999-49152020-02-0112222210.3390/v12020222v12020222Late-Relapsing Hepatitis after Yellow FeverIzabela Maurício Rezende0Leonardo Soares Pereira1Jordana Rodrigues Barbosa Fradico2Marcelo Antônio Pascoal Xavier3Pedro Augusto Alves4Ana Carolina Campi-Azevedo5Elaine Speziali6Lívia Zignago Moreira dos Santos7Natalia Soares Albuquerque8Indiara Penido9Tayrine Araujo Santos10Ana Paula Dinis Ano Bom11Andrea Marques Vieira da Silva12Camilla Bayma Fernandes13Carlos Eduardo Calzavara14Erna Geessien Kroon15Olindo Assis Martins-Filho16Andréa Teixeira-Carvalho17Betânia Paiva Drumond18Laboratório de Vírus, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais 31270-901, BrazilEduardo de Menezes Hospital, Minas Gerais 30622-020, BrazilGrupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilDepartamento de Anatomia Patológica e Medicina Legal, Faculdade de Menincina, Universidade Federal de Minas Gerais, Minas Gerais 31270-901, BrazilImunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilGrupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilGrupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilEduardo de Menezes Hospital, Minas Gerais 30622-020, BrazilEduardo de Menezes Hospital, Minas Gerais 30622-020, BrazilEduardo de Menezes Hospital, Minas Gerais 30622-020, BrazilEduardo de Menezes Hospital, Minas Gerais 30622-020, BrazilLaboratório de Tecnologia Imunológica, Bio-Manguinhos, Fundação Oswaldo Cruz/FIOCRUZ, Rio de Janeiro 21040-900, BrazilLaboratório de Tecnologia Imunológica, Bio-Manguinhos, Fundação Oswaldo Cruz/FIOCRUZ, Rio de Janeiro 21040-900, BrazilLaboratório de Tecnologia Imunológica, Bio-Manguinhos, Fundação Oswaldo Cruz/FIOCRUZ, Rio de Janeiro 21040-900, BrazilImunologia Celular e Molecular, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilLaboratório de Vírus, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais 31270-901, BrazilGrupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilGrupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz/FIOCRUZ, Minas Gerais 30190-002, BrazilLaboratório de Vírus, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Minas Gerais 31270-901, BrazilOne patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepatitis, inflammatory or metabolic liver disease, and new infections caused by hepatotropic agents. Anti-YFV IgM, IgG and neutralizing antibodies were detected in different times, but no viremia. A liver biopsy was collected three months after YF onset and tested positive for YFV antigens and wild-type YFV-RNA (364 RNA-copies/gram/liver). Transaminases and bilirubin levels remained elevated for five months, and the arresting of symptoms persisted for six months after the acute YF onset. Several serum chemokines, cytokines, and growth factors were measured. A similar immune response profile was observed in the earlier phases of the disease, followed by more pronounced changes in the later stages, when transaminases levels returned to normal. The results indicated viral persistence in the liver and continual liver cell damage three months after YF onset and reinforced the need for extended follow-ups of YF patients. Further studies to investigate the role of possible viral persistence and the immune response causing relapsing hepatitis following YF are also necessary.https://www.mdpi.com/1999-4915/12/2/222yellow fever virusyellow feverliver damageviral persistencehepatitisliver biopsypersistent infectionrelapsing hepatitisemerging virusflavivirus |
| spellingShingle | Izabela Maurício Rezende Leonardo Soares Pereira Jordana Rodrigues Barbosa Fradico Marcelo Antônio Pascoal Xavier Pedro Augusto Alves Ana Carolina Campi-Azevedo Elaine Speziali Lívia Zignago Moreira dos Santos Natalia Soares Albuquerque Indiara Penido Tayrine Araujo Santos Ana Paula Dinis Ano Bom Andrea Marques Vieira da Silva Camilla Bayma Fernandes Carlos Eduardo Calzavara Erna Geessien Kroon Olindo Assis Martins-Filho Andréa Teixeira-Carvalho Betânia Paiva Drumond Late-Relapsing Hepatitis after Yellow Fever Viruses yellow fever virus yellow fever liver damage viral persistence hepatitis liver biopsy persistent infection relapsing hepatitis emerging virus flavivirus |
| title | Late-Relapsing Hepatitis after Yellow Fever |
| title_full | Late-Relapsing Hepatitis after Yellow Fever |
| title_fullStr | Late-Relapsing Hepatitis after Yellow Fever |
| title_full_unstemmed | Late-Relapsing Hepatitis after Yellow Fever |
| title_short | Late-Relapsing Hepatitis after Yellow Fever |
| title_sort | late relapsing hepatitis after yellow fever |
| topic | yellow fever virus yellow fever liver damage viral persistence hepatitis liver biopsy persistent infection relapsing hepatitis emerging virus flavivirus |
| url | https://www.mdpi.com/1999-4915/12/2/222 |
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