Vesely D L, Dilley R W, Duckworth W C, Paustian F F
Department of Internal Medicine at the University of South Florida for Health Sciences and James A. Haley Veterans Hospital, Tampa, 33612, USA.
Am J Med Sci. 1999 Jun;317(6):419-24. doi: 10.1097/00000441-199906000-00012.
A 38-year-old otherwise healthy man presented with hepatic failure (aspartate aminotransferase of 7212 U/L, alanine aminotransferase of 6629 U/L, total and direct bilirubin of 10.7 mg/dL) and acute renal failure (creatinine of 11.6 mg/dL and blood urea nitrogen of 42 mg/dL), which required hemodialysis when the creatinine increased to 21 mg/dL, with a blood urea nitrogen of 115 mg/dL, and the patient became oliguric. On admission, this patient also had a lipase of 1833 U/L, amylase of 211 U/L, glucose of 210 mg/dL, and reactive IgM antibody for acute hepatitis A. The hepatitis and acute renal failure resolved in 3 months, but this patient continues to have type II diabetes mellitus 7 years after the hepatitis A infection. This case illustrates that hepatitis A infection may be severe with liver failure, acute renal failure, and permanent diabetes mellitus as sequale of this infection.
一名38岁的健康男性出现肝功能衰竭（天冬氨酸转氨酶7212 U/L，丙氨酸转氨酶6629 U/L，总胆红素和直接胆红素10.7 mg/dL）和急性肾衰竭（肌酐11.6 mg/dL，血尿素氮42 mg/dL），当肌酐升至21 mg/dL、血尿素氮115 mg/dL且患者出现少尿时需要进行血液透析。入院时，该患者还伴有脂肪酶1833 U/L、淀粉酶211 U/L、血糖210 mg/dL以及急性甲型肝炎反应性IgM抗体。肝炎和急性肾衰竭在3个月内得到缓解，但该患者在甲型肝炎感染7年后仍患有2型糖尿病。此病例表明，甲型肝炎感染可能较为严重，可导致肝功能衰竭、急性肾衰竭，并遗留永久性糖尿病作为该感染的后遗症。
