New foe treated with old guns – supportive role of steroids in the treatment of acute severe hepatitis E

BMC Gastroenterology

Henning Wege¹  Ansgar W Lohse¹  Alexander Quaas²  Susanne Polywka⁴  Marc Lütgehetmann¹  Sven Pischke³  Marcial Sebode¹ 

[1] I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany;Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Outpatient Clinic for Liver Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Department of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

关键词: Steroid treatment;    Acute liver injury;    Autochthonous;    Hepatitis E;   

Others  :  1121771
DOI  :  10.1186/s12876-014-0191-0

 received in 2014-05-15, accepted in 2014-10-20,  发布年份 2014

【 摘 要 】

Background

Autochthonous hepatitis E has been observed with growing incidence in industrialized countries. Hepatitis E virus infection causes an acute hepatitis with spontaneous resolution in the majority of cases. However, in individual cases, hepatitis E may lead to life-threatening acute liver failure. In this report, we describe a case of acute liver injury caused by an autochthonous hepatitis E that resolved under steroid treatment. To our knowledge, this is the first case report describing supportive steroid monotherapy for acute liver injury due to hepatitis E.

Case presentation

A 63-year-old Caucasian male presented with acute liver injury of unknown origin. After excluding the most prevalent causes of acute liver injury, liver histology revealed signs of immune-mediated toxic or drug-induced liver injury. Therefore, immunosuppressive treatment with prednisolone was started. After initialization of steroid treatment, polymerase chain reaction analyses of peripheral blood and liver tissue revealed an acute hepatitis E virus infection (genotype 3). Under sustained steroid treatment, acute liver injury improved and hepatitis E infection resolved.

Conclusion

Steroid treatment might be an option to prevent progress of life-threatening liver failure and liver transplantation in patients with hepatitis E-induced acute liver injury and high-grade inflammation.

【 授权许可】

   
2014 Sebode et al.; licensee BioMed Central Ltd.

【 图 表 】

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