Fujiyama Yoichi, Yamagishi Yoshiyuki, Kikuchi Masahiro, Shimoji Kenichiro, Kato Shinzo, Nagata Hiroshi, Saito Hidetsugu, Hibi Toshifumi, Mishiro Syunji
Department of Internal Medicine, School of Medicine, Keio University.
Nihon Shokakibyo Gakkai Zasshi. 2007 Feb;104(2):219-25.
A 40-year-old man, who had suffered from general malaise and brown urine during his stay in China, was admitted with remarkable jaundice and hepatocellular disorders soon after he returned to Japan. Because his coagulation test results worsened, he was transferred to our hospital. No evidence of hepatitis A-D virus infection, autoimmune hepatitis, or metabolic disorders was noticed. His prothrombin time was extended (18%), grade II encephalopathy appeared on the second hospital day, and fulminant hepatitis was diagnosed. Artificial liver support was introduced, and his hepatic coma and coagulation parameters gradually recovered. Genotype IV hepatitis E virus RNA was detected in his early phase sera and also both IgG and IgM type anti-hepatitis E virus antibodies were detected. Fulminant hepatitis E resulting from infection in China was diagnosed.
一名40岁男性,在中国期间出现全身不适和茶色尿,返回日本后不久因明显黄疸和肝细胞紊乱入院。由于其凝血检查结果恶化,被转至我院。未发现甲型至丁型肝炎病毒感染、自身免疫性肝炎或代谢紊乱的证据。他的凝血酶原时间延长(18%),入院第二天出现Ⅱ级肝性脑病,诊断为暴发性肝炎。采用人工肝支持治疗后,其肝昏迷和凝血参数逐渐恢复。在他早期的血清中检测到戊型肝炎病毒IV型RNA,同时还检测到IgG和IgM型抗戊型肝炎病毒抗体。诊断为在中国感染导致的暴发性戊型肝炎。