A Case Report of Acute Liver Failure in a Child with Hepatitis a Virus and Epstein-Barr Virus Coinfection on the Background of Autoimmune Sclerosing Cholangitis.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL International Medical Case Reports Journal Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.2147/IMCRJ.S477802

Sergiy Kramarov, Vitalii Yevtushenko, Iryna Seriakova, Oleksandr Voronov, Nataliia Kyrytsia, Liudmyla Vladislavivna Zakordonets, Valerii Shadrin, Claudia Shatrova, Nataliia Savostikova, Volodymyr Zhezhera

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Abstract

Background: 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.

Case presentation: 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.

Conclusion: The case is novel as regards the occurrence of two viral hepatitis with different modes of transmission on a background of unidentified liver disease.

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一例在自身免疫性硬化性胆管炎背景下合并感染甲型肝炎病毒和 Epstein-Barr 病毒的儿童急性肝功能衰竭的病例报告。

背景：暴发性肝炎是一种罕见的严重急性肝衰竭（ALF），其特点是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 的病因中占重要地位，然而，慢性肝脏病变的存在在疾病进展和 ALF 的发展中也起着重要作用：一名两岁儿童在发病第 4 天因黄疸和全身中毒症状住院。检查结果显示存在活动性甲型肝炎病毒感染和 Epstein-Barr 病毒感染。从发病第 7 天起，患儿的病情开始因 ALF 表现而逐渐恶化。尽管使用了免疫调节和替代疗法，孩子还是在发病第 9 天死亡。病理组织学检查显示，患儿在自身免疫性硬化性胆管炎的背景下出现了病毒性坏死性肝炎的表现：本病例是在不明肝病背景下出现两种不同传播方式的病毒性肝炎的新病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Medical Case Reports Journal MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

135

审稿时长

16 weeks

期刊介绍： International Medical Case Reports Journal is an international, peer-reviewed, open access, online journal publishing original case reports from all medical specialties. Submissions should not normally exceed 3,000 words or 4 published pages including figures, diagrams and references. As of 1st April 2019, the International Medical Case Reports Journal will no longer consider meta-analyses for publication.