Shah Divit, Talwar Dhruv, Kumar Sunil, Acharya Sourya, Hulkoti Vidyashree
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India.
J Family Med Prim Care. 2022 May;11(5):2241-2245. doi: 10.4103/jfmpc.jfmpc_2058_21. Epub 2022 May 14.
Fulminant hepatitis is a potentially life-threatening disease that is evident through the findings of organ dysfunction, jaundice, and hepatomegaly, which is painful. Dysfunction of the endothelial cells and thus the damage of the endothelium is the probable mechanism, which is responsible for causing complications of hepatobiliary system in patients with sickle cell disease. Various acute as well as chronic manifestations of the hepatobiliary system, having varied severity and pathophysiology are associated with sickle cell disease. Dengue fever may also affect the liver starting from asymptomatic liver enzyme derangement to fulminant hepatic failure. This case series describes the first ever association of fulminant hepatic failure resulting from the synergistic effect of dengue fever with sickle cell disease and thus highlights the importance of prevention of dengue fever in sickle cell patients, thereby preventing potentially lethal fulminant hepatic failure.
暴发性肝炎是一种潜在的危及生命的疾病，通过器官功能障碍、黄疸和肝肿大（伴有疼痛）的表现得以显现。内皮细胞功能障碍进而导致内皮损伤可能是其机制，这会引发镰状细胞病患者的肝胆系统并发症。镰状细胞病与肝胆系统的各种急慢性表现相关，其严重程度和病理生理各不相同。登革热也可能影响肝脏，从无症状的肝酶紊乱到暴发性肝衰竭。本病例系列描述了登革热与镰状细胞病协同作用导致暴发性肝衰竭的首例关联，从而凸显了在镰状细胞病患者中预防登革热的重要性，进而预防潜在致命的暴发性肝衰竭。
