| BMC Research Notes | |
| Fatal hepatitis E viral infection in pregnant women in Ghana: a case series | |
| Mubarak Osei-Kwesi1  Samuel Antwi Oppong2  Naa Baake Armah2  Jacob Samson Barnor1  Ama Asantewa Tamatey2  Samuel Obed2  Robert A Kwame-Aryee2  Joseph Humphrey Kofi Bonney1  | |
| [1] Noguchi Memorial Institute for Medical Research, School of health Sciences, University of Ghana, Accra, Ghana;Department of Obstetrics and Gynaecology, Korle-Bu Teaching Hospital, P.O. Box KB 82, Accra, Ghana | |
| 关键词: Hepatitis E virus; Fulminant hepatic failure; Fulminant hepatitis; | |
| Others : 1165796 DOI : 10.1186/1756-0500-5-478 |
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| received in 2012-06-08, accepted in 2012-08-23, 发布年份 2012 | |
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【 摘 要 】
Background
Viral infections during pregnancy can pose serious threats to mother and fetus from the time of conception to the time of delivery. These lead to congenital defects, spontaneous abortion and even death. The definitive diagnosis and management of pregnancy-related viral infections may be challenging especially in less resourced countries.
Case presentation
We present clinical and laboratory responses to the diagnosis and management of three cases of fulminant hepatitis secondary to Hepatitis E viral infection in pregnancy.
Case 1 was a 31-year-old Ghanaian woman who presented with a week’s history of passing dark urine as well as yellowish discoloration of the eyes. She subsequently developed fulminant hepatitis secondary to Hepatitis E viral infection, spontaneously aborted at 24 weeks of gestation and later died.
Case 2 was also a 31-year-old Ghanaian woman who was admitted with a four-day history of jaundice. She had low grade fever, but no history of abdominal pain, haematuria, pale stool or pruritus. She next developed fulminant hepatitis secondary to Hepatitis E viral infection. However, she did not miscarry but died at 28 weeks of gestation.
Case 3 was a 17-year-old Ghanaian woman who was referred to the tertiary health facility on account of jaundice and anaemia. She had delivered a live male infant at maturity of 32 weeks but noticed she was jaundiced and had a presentation of active disease 3 days prior to delivery. The baby was icteric at birth and on evaluation, had elevated bilirubin (mixed type) with normal liver enzymes. Hepatitis E virus infection was confirmed in both mother and baby. However, the jaundice and the hepatomegaly resolved in mother and baby after 5 and 12 days respectively.
Conclusion
To the best of our knowledge, these are the first documented cases of fatal fulminant hepatic failures resulting from HEV infection in Ghana.
【 授权许可】
2012 Bonney et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150416033748370.pdf | 245KB | ||
| Figure 1. | 108KB | Image |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Aggarwal R, Krawczynski K: Hepatitis E: an overview and recent advances in clinical and laboratory research. J Gastroenterol Hepatol 2000, 15(1):9-20.
- [2]Zhu F-C, et al.: Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large scale randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet 2010, 376:895-902.
- [3]Adjei AA, Yao T, Aviyase JT, Clement A-G, Samuel O, Julius AA M, Ayeh-Kumi PF, Adiku TK: Hepatitis E virus infection is highly prevalent among pregnant women in Accra, Ghana. Virol J 2009, 6(108):1-5.
- [4]Pierre V, Drouet MT, Deubel V: “Identification of mosquito-borne flavivirus sequences using universal primers and reverse transcription/polymerase chain reaction”. Res Virol 1994, 145:93-104.
- [5]Katano H, Kano M, Nakamura T, Kanno T, Asanuma H, Sata T: A novel real-time PCR system for simultaneous detection of human viruses in clinical samples with uncertain aetiology. J Med Virol 2011, 83:322-330.
- [6]Wetteland P, Røger M, Solberg HE, Iversen OH: “Population-based erythrocyte sedimentation rates in 3910 subjectively healthy Norwegian adults. A statistical study based on men and women from the Oslo area”. J Intern Med 1996, 240(3):125-131.
- [7]Nyblom H, Berggren U, Balldin J, Olsson R: High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking. Alcohol 2004, 39(4):336-339.
- [8]Sorbi D, Boynton J, Lindor KD: The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease. Am J Gastroenterol 1999, 94(4):1018-1022.
- [9]Patra S, Kumar A, Trivedi SS, et al.: Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med 2007, 147(1):28-33.
- [10]Khuroo MS, Teli MR, Skidmore S, Sofi MA, Khuroo MI: Incidence and severity of viral hepatitis in pregnancy. Am J Med 1981, 70:252-255.
- [11]Singh S, Mohanty A, Joshi YK, Deka D, Mohanty S, Panda SK: Mother-to-child transmission of hepatitis E virus infection. Indian J Pediatr 2003, 70:37-39.
- [12]Jilani N, Das BC, Husain SA, Baweja UK, Chattopadhya D, Gupta RK, Sardana S, Kar P: Hepatitis E virus infection and fulminant hepatic failure during pregnancy. J Gastroenterol Hepatol 2007, 22:676-679.
- [13]Khuroo MS, Kamili S: Clinical course and duration of viremia in vertically transmitted hepatitis E virus (HEV) infection in babies born to HEV-infected mothers. Journal of Viral Hepatitis 2009, 16:519-523.
- [14]Khuroo MS, Kamili S: Association of severity of hepatitis E virus infection in the mother and vertically transmitted infection in the fetus. JK Pract 2006, 13:70-74.
- [15]Aggarwal R, Jameel S: Hepatitis E vaccine. Hepatol Int 2008, 2(3):308-315.
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