Oliveira Ana, Valadares Diana, Nery Felipe
Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Unidade de Cuidados Intermédios Médicos, Serviço de Cuidados Intensivos, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Eur J Case Rep Intern Med. 2021 Feb 12;8(3):002270. doi: 10.12890/2021_002270. eCollection 2021.
Despite worldwide vaccination campaigns, hepatitis B virus (HBV) infection remains a major public health problem. The natural history ranges from asymptomatic infection to severe liver injury or failure, chronic complications or reactivation episodes. The effects of HBV on the organism are immunomediated, possibly triggering extrahepatic manifestations. Since 1971, only a few cases of pleural effusion related to HBV infection have been described. We report HBV-associated pleural effusion occurring during a viral reactivation episode. Antiviral treatment directed towards pleural effusion related to HBV infection should be dictated by underlying liver disease severity and not pleural effusion severity.
In the presence of pleural effusion of unknown origin, especially if with simultaneous acute hepatitis, a viral aetiology should be suspected and pursued.The severity of liver disease and not the pleural effusion should guide antiviral treatment.
尽管全球开展了疫苗接种运动，但乙型肝炎病毒（HBV）感染仍然是一个主要的公共卫生问题。其自然病程范围从无症状感染到严重肝损伤或衰竭、慢性并发症或再激活发作。HBV对机体的影响是免疫介导的，可能引发肝外表现。自1971年以来，仅描述了少数与HBV感染相关的胸腔积液病例。我们报告了在病毒再激活发作期间发生的HBV相关性胸腔积液。针对与HBV感染相关的胸腔积液的抗病毒治疗应根据潜在肝病的严重程度而非胸腔积液的严重程度来决定。
在存在不明原因胸腔积液的情况下，尤其是同时伴有急性肝炎时，应怀疑并追查病毒病因。肝病的严重程度而非胸腔积液应指导抗病毒治疗。
