de-Hoyos A, Loredo M L, Henne O, Guzmán C, Kuri J
Departamento de Gastroenterología, Instituto Nacional de Cardiología, Ignacio Chávez, México, D.F.
Rev Invest Clin. 1997 May-Jun;49(3):237-9.
We report the case of a young man first seen by is in 1989 at the age of 20 years. The diagnoses of hypertrophic cardiomyopathy, Wolf-parkinson-White syndrome, congestive heart failure and pulmonary hypertension were made. One month later the patient had jaundice and hepatomegaly and a diagnosis of acute viral hepatitis A was established by laboratory findings. The ALT and AST levels were persistently elevated, seven times the normal mean, during six years. Two liver biopsies in 1991 and 1993 showed liver injury secondary to congestive heart failure (CHF) as the only abnormality. This case illustrates the importance of liver injury secondary to CHF as a cause of a marked and persistent increase of ALT and AST that resembles that of other liver diseases.
我们报告一例年轻男性病例，其于1989年首次就诊，当时20岁。诊断为肥厚型心肌病、预激综合征、充血性心力衰竭和肺动脉高压。一个月后，患者出现黄疸和肝肿大，实验室检查结果确诊为急性甲型病毒性肝炎。在六年时间里，谷丙转氨酶（ALT）和谷草转氨酶（AST）水平持续升高，是正常均值的七倍。1991年和1993年的两次肝脏活检显示，唯一异常为充血性心力衰竭（CHF）继发的肝损伤。该病例说明了CHF继发肝损伤作为导致ALT和AST显著持续升高的原因的重要性，这种升高类似于其他肝脏疾病所致。
