Deutsche medizinische Wochenschrift (1946) · 2011
[Hepatitis A - combined prolonged biphasic and cholestatic course of disease].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Schmidt L, Zachoval R, Diepolder H, Kolligs F T
Аннотация
HISTORY AND ADMISSION FINDINGS: One month after a first manifestation of a hepatitis A infection and transaminases had become normal, a 44-year-old woman again became jaundiced with accompanied by weakness, nausea and nocturnal sweating.
INVESTIGATIONS: Laboratory tests again showed features of hepatitis with decreased synthetic liver function and hyperbilirubinemia, changes which persisted for 12 weeks. Serological and virological studies revealed a positive test for anti-hepatitis A virus (HAV) IgM and HAV-RNA was detected in the stool.
DIAGNOSIS, TREATMENT AND COURSE: These tests demonstrated two rare features of hepatitis A, namely a prolonged biphasic course combined with cholestasis form. In addition a hemolytic anaemia developed.
CONCLUSION: The severity of a relapse of hepatitis A varies: in this case it was more severe than the initial manifestation. The reasons for the different courses of hepatitis A infection remain unclear.
INVESTIGATIONS: Laboratory tests again showed features of hepatitis with decreased synthetic liver function and hyperbilirubinemia, changes which persisted for 12 weeks. Serological and virological studies revealed a positive test for anti-hepatitis A virus (HAV) IgM and HAV-RNA was detected in the stool.
DIAGNOSIS, TREATMENT AND COURSE: These tests demonstrated two rare features of hepatitis A, namely a prolonged biphasic course combined with cholestasis form. In addition a hemolytic anaemia developed.
CONCLUSION: The severity of a relapse of hepatitis A varies: in this case it was more severe than the initial manifestation. The reasons for the different courses of hepatitis A infection remain unclear.