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病例报告:登革热病毒引发孕妇自身免疫性肝炎,首发表现为肝衰竭。

Case report: liver failure as a debut of autoimmune hepatitis triggered by dengue virus in a pregnant woman.

机构信息

Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Perú.

Facultad de Medicina, Universidad Peruana Cayetano Heredia (UPCH), Lima, Perú.

出版信息

Rev Peru Med Exp Salud Publica. 2024 Aug 19;41(2):209-213. doi: 10.17843/rpmesp.2024.412.13485.

Abstract

Autoimmune hepatitis (AIH) is a complex condition with unclear origins, involving genetic susceptibility and environmental triggers that lead to immune system dysfunction. We report a case of a pregnant woman from a mosquito-borne disease-endemic area who presented jaundice, abdominal pain, and pruritus, complicated by acute liver failure. Immunological markers showed AIH triggered by dengue virus infection, which was confirmed by a positive IgM test. Treatment with supportive care followed by steroids and azathioprine resulted in favorable outcomes, averting the need for a liver transplant. Although AIH can be triggered by viruses, the role of dengue in its pathogenesis remains poorly understood. Regular clinical monitoring is vital for managing AIH, particularly during pregnancy, due to variable immune status and treatment responses. Further research is necessary to understand the link between dengue infection and AIH. Individualized treatment strategies are crucial, especially during pregnancy, in order to ensure favorable outcomes.

摘要

自身免疫性肝炎(AIH)是一种病因不明的复杂疾病,涉及遗传易感性和环境触发因素,导致免疫系统功能障碍。我们报告了一例来自蚊媒疾病流行地区的孕妇病例,她出现黄疸、腹痛和瘙痒,并伴有急性肝功能衰竭。免疫标志物显示 AIH 是由登革热病毒感染引发的,这通过 IgM 检测阳性得到了证实。采用支持性治疗,随后使用类固醇和硫唑嘌呤进行治疗,结果良好,避免了肝移植的需要。虽然 AIH 可由病毒引发,但登革热在其发病机制中的作用仍不清楚。由于免疫状态和治疗反应的变化,定期进行临床监测对于 AIH 的管理至关重要,特别是在怀孕期间。需要进一步研究以了解登革热感染与 AIH 之间的联系。个体化治疗策略至关重要,特别是在怀孕期间,以确保良好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de89/11300697/164cc2aa4fab/rpmesp-41-02-13485-g001.jpg

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