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以多器官功能障碍为表现的急性甲型肝炎病毒感染:一例报告

Acute hepatitis a virus infection presenting with multiorgan dysfunction: a case report.

作者信息

Rasheed Abdul, Saeed Shahzad

机构信息

Combined Military Hospital Rawalpindi Pakistan.

出版信息

Cases J. 2009 Jul 30;2:8124. doi: 10.4076/1757-1626-2-8124.

Abstract

INTRODUCTION

Acute hepatitis due to hepatitis a virus is usually a benign self-limiting disease conferring lifelong immunity. However, few cases have been reported in literature with fulminant hepatitis. We report this extremely rare case with multiorgan dysfunction including liver failure, hepatic encephalopathy, renal failure, pleural effusion, pericardial effusion and hematologic dysfunction as a sequale of this infection in an otherwise healthy male at the age of 18.

CASE PRESENTATION

An 18 years old Pakistani male presented with two days history of fever, cough, headache and vomiting. His condition gradually deteriorated and on day 7 developed multiorgan dysfunction. Initially Immunoglobulin M anti hepatitis a virus was borderline 1.40 but repeated titers one week later confirmed the diagnosis of acute hepatitis a virus infection.

CONCLUSION

This original case report highlights the importance of focusing first uncommon manifestations of common illnesses while diagnosing difficult cases. Moreover this case also adds knowledge to the limited available data regarding complications and predictors of prognosis.

摘要

引言

甲型肝炎病毒引起的急性肝炎通常是一种良性自限性疾病,可赋予终身免疫力。然而,文献中报道的暴发性肝炎病例很少。我们报告了这一极为罕见的病例,一名18岁原本健康的男性在感染后出现多器官功能障碍,包括肝衰竭、肝性脑病、肾衰竭、胸腔积液、心包积液和血液学功能障碍。

病例介绍

一名18岁的巴基斯坦男性出现发热、咳嗽、头痛和呕吐两天。他的病情逐渐恶化,在第7天出现多器官功能障碍。最初,抗甲型肝炎病毒免疫球蛋白M处于临界值1.40,但一周后重复检测滴度证实了急性甲型肝炎病毒感染的诊断。

结论

这份原始病例报告强调了在诊断疑难病例时关注常见疾病不常见表现的重要性。此外,该病例也为关于并发症和预后预测因素的有限现有数据增添了知识。

相似文献

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本文引用的文献

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Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C.
N Engl J Med. 1998 Jan 29;338(5):286-90. doi: 10.1056/NEJM199801293380503.
10
Genetic relatedness of hepatitis A virus strains recovered from different geographical regions.
J Gen Virol. 1992 Jun;73 ( Pt 6):1365-77. doi: 10.1099/0022-1317-73-6-1365.

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