Dr Chanchal Kumar Ghosh, Associate Professor, Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2021 Apr;30(2):559-561.
Hepatitis A virus (HAV) is the most common cause of acute viral hepatitis in the world. Infection with hepatitis A virus can cause severe or even fatal illness in patients with chronic liver disease. Here we present a case which seems to be an isolated acute viral hepatitis A infection at the beginning but later found to be coexisted with Wilson's disease. A 14-year-old girl presented in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 11th April 2019 with progressive jaundice with prodrome, dark urine, itching, hepatomegaly and thyromegaly. She was found positive for serum IgM HAV antibody. Her jaundice was increasing along with prolonged prothrombin time and low albumin. She had coexisting Wilson's disease evidenced by increased 24 hours urinary copper (138μgm/day). She was treated with D-Penicillamine and Zinc acetate. Hepatitis A can be considered as a factor for acute decompensation in undiagnosed patients with Wilson's disease. So it is very crucial to investigate Wilson's disease in appropriate clinical setting of prolonged jaundice and liver dysfunction.
甲型肝炎病毒（HAV）是世界上引起急性病毒性肝炎的最常见原因。感染甲型肝炎病毒可导致慢性肝病患者发生严重甚至致命的疾病。在这里，我们报告了一例患者，起初似乎是孤立性急性甲型肝炎病毒感染，但后来发现同时患有威尔逊病。2019 年 4 月 11 日，一名 14 岁女孩因进行性黄疸伴前驱症状、深色尿、瘙痒、肝肿大和甲状腺肿大到孟加拉国达卡的 Bangabandhu Sheikh Mujib 医学大学（BSMMU）消化内科就诊。她的血清 IgM HAV 抗体呈阳性。她的黄疸随着延长的凝血酶原时间和低白蛋白而增加。她同时患有威尔逊病，24 小时尿铜（138μgm/天）增加。她接受了 D-青霉胺和醋酸锌治疗。甲型肝炎可被认为是未确诊威尔逊病患者急性失代偿的一个因素。因此，在长时间黄疸和肝功能障碍的适当临床环境下，对威尔逊病进行调查非常关键。
