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急性戊型肝炎:临床和实验室诊断。

Acute HEV hepatitis: clinical and laboratory diagnosis.

机构信息

Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2019 Jan;23(2):764-770. doi: 10.26355/eurrev_201901_16891.

Abstract

OBJECTIVE

Hepatitis E Virus (HEV) is probably the most common cause of acute hepatitis worldwide. It has been regarded for a long time as a disease limited to developing countries. Recently, the refinement of diagnostic techniques, on the one hand, and migratory flows, on the other hand, have also led to the identification of an increased number of HEV infections in industrialized countries. Four HEV genotypes have been identified across the world, with different epidemiological burdens and a wide range of clinical presentations. Here, we report a case series of acute HEV hepatitis observed in the last three years in our hospital.

PATIENTS AND METHODS

We performed a search for HEV IgM and IgG in all subjects admitted for acute hepatitis without evidence of other possible infectious, toxic or metabolic causes of liver damage. In subjects with HEV IgM positivity, the search for HEV-RNA was performed.

RESULTS

We diagnosed eight acute HEV infections: 2 epidemic and 6 sporadic forms. HEV-RNA was detected in serum in 2 cases.

CONCLUSIONS

HEV infection appears to be a cause of acute hepatitis that we must keep in mind even in developed countries.

摘要

目的

戊型肝炎病毒(HEV)可能是全球最常见的急性肝炎病因。长期以来,它一直被认为是一种仅限于发展中国家的疾病。最近,一方面诊断技术的改进,另一方面移民流动,也导致在工业化国家发现了越来越多的 HEV 感染。全球已鉴定出 4 种 HEV 基因型,具有不同的流行病学负担和广泛的临床表现。在这里,我们报告了过去三年在我们医院观察到的急性 HEV 肝炎的一系列病例。

患者和方法

我们对所有因急性肝炎入院且无其他可能的传染性、毒性或代谢性肝损伤原因的患者进行了 HEV IgM 和 IgG 检测。对于 HEV IgM 阳性的患者,我们进行了 HEV-RNA 检测。

结果

我们诊断了 8 例急性 HEV 感染:2 例为流行型,6 例为散发型。在 2 例血清中检测到了 HEV-RNA。

结论

HEV 感染似乎是急性肝炎的一个病因,即使在发达国家也不容忽视。

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