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细小病毒B19感染所致急性肝炎伴肝脾肿大及多关节病

Parvovirus b19-Induced Acute Hepatitis With Hepatosplenomegaly and Polyarthropathy.

作者信息

Khan Ubaid, Uzair Ahmad Rana, Ullah Zabeeh, Fida Tooba, Shehryar Muhammad

机构信息

Department of Medicine, Mayo Hospital, Lahore, PAK.

Department of Internal Medicine, Mayo Hospital, Lahore, PAK.

出版信息

Cureus. 2022 Jan 22;14(1):e21494. doi: 10.7759/cureus.21494. eCollection 2022 Jan.

Abstract

Parvovirus B19 infection can present with myriads of clinical diseases and syndromes; hepatitis and polyarthropathy are a few of these examples. Parvovirus frequently affects children but this condition has also been reported in adults.  The present case report discusses a case of a 43-year-old female who presented to the outpatient department (OPD) with complaints of high-grade fever and pain in multiple joints of her body for three days. On examination, stiffness and swelling of the hand, knees, wrist, and ankles were noted. Laboratory investigations showed highly elevated aspartate transaminase (AST), alanine transaminase (ALT), and bilirubin. Electrocardiogram (ECG) and echocardiogram (ECHO) findings were unremarkable. PCR testing showed the presence of parvovirus. Parvovirus B19 infection led to the development of acute hepatitis, which appeared as yellowing of skin (jaundice) and led to hepatosplenomegaly. Parvovirus-induced polyarthropathy was also observed in the patient. The patient was managed with a parenteral course of ceftriaxone, paracetamol, and a normal saline infusion. Anti-viral drugs were also prescribed to the patient including ribavirin and pegylated interferon. This case study will explore how the patient was diagnosed and managed with conventional therapy and anti-viral to relieve parvovirus-induced hepatitis with hepatosplenomegaly and polyarthritis. Acute hepatitis can be caused by viruses and other noninfectious causes, all of which must be cleared out to avoid chronic disease development. When patients present with joint pain and skin rashes, a thorough workup for viral indicators, medication histories, autoimmune and metabolic illnesses, and parvovirus b19 infection is required.

摘要

细小病毒B19感染可表现为多种临床疾病和综合征;肝炎和多关节病就是其中的一些例子。细小病毒常感染儿童,但成人中也有相关病例报道。本病例报告讨论了一名43岁女性,她因高热和全身多个关节疼痛三天就诊于门诊。检查时,发现手部、膝盖、手腕和脚踝有僵硬和肿胀。实验室检查显示天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和胆红素高度升高。心电图(ECG)和超声心动图(ECHO)检查结果无异常。PCR检测显示存在细小病毒。细小病毒B19感染导致了急性肝炎,表现为皮肤发黄(黄疸)并导致肝脾肿大。患者还出现了细小病毒引起的多关节病。患者接受了头孢曲松、对乙酰氨基酚的肠外治疗以及生理盐水输注。还为患者开了抗病毒药物,包括利巴韦林和聚乙二醇干扰素。本病例研究将探讨该患者如何通过传统疗法和抗病毒药物进行诊断和治疗,以缓解细小病毒引起的肝炎伴肝脾肿大和多关节炎。急性肝炎可由病毒和其他非感染性原因引起,所有这些病因都必须清除以避免发展为慢性病。当患者出现关节疼痛和皮疹时,需要对病毒指标、用药史、自身免疫和代谢疾病以及细小病毒B19感染进行全面检查。

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