单纯疱疹病毒肝炎导致妊娠期急性肝功能障碍和血小板减少症。
Herpes simplex virus hepatitis causing acute liver dysfunction and thrombocytopenia in pregnancy.
作者信息
Allen Rebecca H, Tuomala Ruth E
机构信息
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
出版信息
Obstet Gynecol. 2005 Nov;106(5 Pt 2):1187-9. doi: 10.1097/01.AOG.0000160481.11517.a0.
BACKGROUND
Herpes simplex virus (HSV) hepatitis in pregnant women is a rare condition. We report a case confirmed by liver biopsy and successfully treated with empiric intravenous acyclovir.
CASE
A 25-year-old primigravida at 34 weeks of gestation presented with fever, thrombocytopenia, and markedly elevated liver enzymes. The patient was treated empirically and was delivered by cesarean. After delivery failed to correct her condition, a liver biopsy revealed HSV hepatitis. The fetus was unaffected and the patient recovered with an extended course of acyclovir.
CONCLUSION
Pregnant women are susceptible to disseminated HSV causing hepatitis. A high index of suspicion is necessary to diagnose HSV hepatitis and begin appropriate treatment with acyclovir. Herpes simplex virus hepatitis should be included in the differential diagnosis for liver failure during pregnancy.
背景
孕妇单纯疱疹病毒（HSV）肝炎是一种罕见疾病。我们报告一例经肝活检确诊并经经验性静脉注射阿昔洛韦成功治疗的病例。
病例
一名25岁初产妇，孕34周，出现发热、血小板减少和肝酶显著升高。对该患者进行了经验性治疗，并通过剖宫产分娩。分娩后病情未得到改善，肝活检显示为HSV肝炎。胎儿未受影响，患者经延长疗程的阿昔洛韦治疗后康复。
结论
孕妇易发生播散性HSV感染导致肝炎。诊断HSV肝炎并开始使用阿昔洛韦进行适当治疗需要高度的怀疑指数。单纯疱疹病毒肝炎应列入妊娠期肝衰竭的鉴别诊断。
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