[Severe acute cholestatic viral hepatitis E in a non-pregnant woman].

HISTORY AND CLINICAL FINDINGS: During a journey in Germany a 25-year-old French woman, who had been living in India for 6 months, developed a severe acute hepatitis with marked jaundice and transitory liver failure.

INVESTIGATIONS: Serum titres for anti-hepatitis E virus immunoglobulins G and M were markedly raised during hospitalisation, proving acute hepatitis E, a rare disease in Central Europe.

TREATMENT AND COURSE: Within two weeks symptomatic treatment brought about almost complete regression of the initially greatly increased parameters of abnormal liver function (GPT 2277 U/l, GOT 1497 U/l, GLDH 39.2 U/l); reduction of the total bilirubin level from initially 11.7 to 1.0 mg/dl). Indicators of decreased liver synthesis, such as antithrombin III, partial thromboplastin time and coagulation factors II, V and VII, quickly became normal. Flue-like and gastrointestinal symptoms and arthralgia, improved within a few days.

CONCLUSION

This case documents the sporadic occurrence in Germany and the course of severe acute hepatitis E, associated with marked liver damage. It demonstrates that the disease can take a fulminant course even in non-pregnant women, leading to severe impairment of liver function and the danger of hepatic coma.