Kramarov Sergiy, Yevtushenko Vitalii, Seriakova Iryna, Voronov Oleksandr, Kyrytsia Nataliia, Zakordonets Liudmyla Vladislavivna, Shadrin Valerii, Shatrova Claudia, Savostikova Nataliia, Zhezhera Volodymyr
Department of Pediatric Infectious Diseases, Bogomolets National Medical University, Kyiv, Ukraine.
Department of Morphology, Clinical Pathology and Forensic Medicine, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine.
Int Med Case Rep J. 2024 Sep 26;17:801-807. doi: 10.2147/IMCRJ.S477802. eCollection 2024.
Fulminant hepatitis is a rare and severe form of acute liver failure (ALF) characterized by rapid and massive destruction of liver cells and associated with a high mortality rate. Infectious factors, in particular viral hepatitis, take a prominent place in the etiology of ALF, however, the presence of chronic liver pathology can play a significant role in the disease progression and development of ALF.
A 2-year-old child was hospitalized on the 4th day of the disease with manifestations of jaundice and general intoxication. The examination revealed markers of active hepatitis A virus infection and Epstein-Barr virus infection. From the seventh day of the disease, the child's condition began to progressively deteriorate due to manifestations of ALF. Despite the use of immunomodulatory and replacement therapy, the disease ended fatally on the 9th day. Pathohistological examination revealed manifestations of viral necrotic hepatitis on the background of autoimmune sclerosing cholangitis.
The case is novel as regards the occurrence of two viral hepatitis with different modes of transmission on a background of unidentified liver disease.
暴发性肝炎是急性肝衰竭(ALF)的一种罕见且严重的形式,其特征为肝细胞迅速大量破坏,死亡率高。感染因素,尤其是病毒性肝炎,在ALF的病因中占显著地位,然而,慢性肝脏病变的存在可在ALF的疾病进展和发展中发挥重要作用。
一名2岁儿童在疾病第4天因黄疸和全身中毒症状住院。检查发现甲型肝炎病毒感染和爱泼斯坦-巴尔病毒感染的标志物。从疾病第7天起,由于ALF的表现,患儿病情开始逐渐恶化。尽管使用了免疫调节和替代疗法,疾病仍在第9天致命。病理组织学检查显示在自身免疫性硬化性胆管炎背景下有病毒性坏死性肝炎的表现。
该病例在未明确的肝脏疾病背景下出现两种不同传播方式的病毒性肝炎,具有新颖性。