Oe Shinji, Shibata Michihiko, Miyagawa Koichiro, Honma Yuichi, Hiura Masaaki, Abe Shintaro, Harada Masaru
Shinji Oe, Michihiko Shibata, Koichiro Miyagawa, Yuichi Honma, Masaaki Hiura, Shintaro Abe, Masaru Harada, Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
World J Gastroenterol. 2015 Aug 28;21(32):9671-4. doi: 10.3748/wjg.v21.i32.9671.
A 58-year-old man was admitted to our hospital. Laboratory data showed severe liver injury and that the patient was positive for immunoglobulin M anti-hepatitis A virus (HAV) antibodies. He was also complicated with severe renal dysfunction and had an extremely high level of serum hepatocyte growth factor (HGF). Therefore, he was diagnosed with severe acute liver failure with acute renal failure (ARF) caused by HAV infection. Prognosis was expected to be poor because of complications by ARF and high serum HGF. However, liver and renal functions both improved rapidly without intensive treatment, and he was subsequently discharged from our hospital on the 21(st) hospital day. Although complication with ARF and high levels of serum HGF are both important factors predicting poor prognosis in acute liver failure patients, the present case achieved a favorable outcome. Endogenous HGF might play an important role as a regenerative effector in injured livers and kidneys.
一名58岁男性入院。实验室检查显示严重肝损伤,且患者抗甲型肝炎病毒(HAV)免疫球蛋白M抗体呈阳性。他还并发严重肾功能不全,血清肝细胞生长因子(HGF)水平极高。因此,他被诊断为甲型肝炎病毒感染所致的严重急性肝衰竭伴急性肾衰竭(ARF)。由于ARF并发症和血清HGF水平高,预计预后不良。然而,未经强化治疗,肝脏和肾功能均迅速改善,随后在住院第21天出院。虽然ARF并发症和血清HGF水平高都是急性肝衰竭患者预后不良的重要预测因素,但本例取得了良好结局。内源性HGF可能在受损肝脏和肾脏中作为再生效应因子发挥重要作用。