Severe Acute Hepatitis E in a Woman with an Autoimmune Background

Detalhes bibliográficos
Autor(a) principal: Nascimento, Maria S.J.
Data de Publicação: 2020
Outros Autores: Almeida-Santos, Madalena, Fernandes, Maria, Maltez, Fernando, Lino, Sara, Curran, Martin D., Mesquita, João R.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429
Resumo: Hepatitis E virus genotype 3 infections are normally asymptomatic in immunocompetent individuals. Symptomatic cases of acute icteric hepatitis E are seldom observed among women, younger men and children but are particularly seen in middle-aged/elderly men. We report a case of severe acute hepatitis E caused by genotype 3 in an immunocompetent 40-year-old woman that required prolonged hospitalization. Her medical history included an autoimmune background, namely atrophic gastritis and Graves’ disease. She presented an extensive hepatic necrosis as revealed by the high levels of aminotransferases (ALT 4893 U/L; AST 3138 U/L). She showed also a coagulation disorder (prothrombin time; INR = 1.33). Serological markers for hepatitis viruses A, B and C were negative but serum was positive for hepatitis E virus RNA. Sequencing and phylogenetic analysis revealed that the hepatitis E virus strain belonged to subgenotype 3a. This is suggestive of an association between the severe acute hepatitis E virus genotype 3 infection and the autoimmune background.
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spelling Severe Acute Hepatitis E in a Woman with an Autoimmune BackgroundHepatite E Aguda Severa em Mulher com História Auto-imuneAcute DiseaseAutoimmune DiseasesHepatitis EHepatitis E virusDoença AgudaDoenças AutoimunesHepatite E/imunologiaVírus da Hepatite EHepatitis E virus genotype 3 infections are normally asymptomatic in immunocompetent individuals. Symptomatic cases of acute icteric hepatitis E are seldom observed among women, younger men and children but are particularly seen in middle-aged/elderly men. We report a case of severe acute hepatitis E caused by genotype 3 in an immunocompetent 40-year-old woman that required prolonged hospitalization. Her medical history included an autoimmune background, namely atrophic gastritis and Graves’ disease. She presented an extensive hepatic necrosis as revealed by the high levels of aminotransferases (ALT 4893 U/L; AST 3138 U/L). She showed also a coagulation disorder (prothrombin time; INR = 1.33). Serological markers for hepatitis viruses A, B and C were negative but serum was positive for hepatitis E virus RNA. Sequencing and phylogenetic analysis revealed that the hepatitis E virus strain belonged to subgenotype 3a. This is suggestive of an association between the severe acute hepatitis E virus genotype 3 infection and the autoimmune background.As infeções pelo vírus da hepatite E do genótipo 3 são normalmente assintomáticas em indivíduos imunocompetentes. Os casos sintomáticos de hepatite E aguda ictérica são raramente observados em mulheres, crianças e jovens adultos, sendo mais frequentes em homens de meia-idade e idosos. Descrevemos um caso de hepatite aguda severa com hospitalização prolongada numa mulher imunocompetente de 40 anos causada pelo vírus da hepatite E do genótipo 3. Da sua história clínica destacavam-se doenças autoimunes, nomeadamente gastrite atrófica e doença de Graves. A mulher apresentava uma necrose hepática grave, revelada pelos altos níveis de aminotransferases (ALT 4893 U/L; AST 3138 U/L), e distúrbios de coagulação (tempo de protrombina; INR = 1,33). Os marcadores serológicos para os vírus das hepatites A, B e C foram negativos; a pesquisa de ARN do vírus da hepatite E foi positiva no soro. A sequenciação e a análise filogenética revelaram que o vírus da hepatite E em causa pertencia ao subgenótipo 3a. Os autores sugerem uma associação entre a infeção aguda severa causada pelo vírus da hepatite E genótipo 3 e o historial autoimune da mulher.Ordem dos Médicos2020-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/tiffapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429oai:ojs.www.actamedicaportuguesa.com:article/10429Acta Médica Portuguesa; Vol. 33 No. 6 (2020): June; 425-428Acta Médica Portuguesa; Vol. 33 N.º 6 (2020): Junho; 425-4281646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429/5785https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429/10072https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429/10777https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429/10778https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429/11283https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10429/11293Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessNascimento, Maria S.J.Almeida-Santos, MadalenaFernandes, MariaMaltez, FernandoLino, SaraCurran, Martin D.Mesquita, João R.2022-12-20T11:05:58Zoai:ojs.www.actamedicaportuguesa.com:article/10429Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:53.155758Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Severe Acute Hepatitis E in a Woman with an Autoimmune Background
Hepatite E Aguda Severa em Mulher com História Auto-imune
title Severe Acute Hepatitis E in a Woman with an Autoimmune Background
spellingShingle Severe Acute Hepatitis E in a Woman with an Autoimmune Background
Nascimento, Maria S.J.
Acute Disease
Autoimmune Diseases
Hepatitis E
Hepatitis E virus
Doença Aguda
Doenças Autoimunes
Hepatite E/imunologia
Vírus da Hepatite E
title_short Severe Acute Hepatitis E in a Woman with an Autoimmune Background
title_full Severe Acute Hepatitis E in a Woman with an Autoimmune Background
title_fullStr Severe Acute Hepatitis E in a Woman with an Autoimmune Background
title_full_unstemmed Severe Acute Hepatitis E in a Woman with an Autoimmune Background
title_sort Severe Acute Hepatitis E in a Woman with an Autoimmune Background
author Nascimento, Maria S.J.
author_facet Nascimento, Maria S.J.
Almeida-Santos, Madalena
Fernandes, Maria
Maltez, Fernando
Lino, Sara
Curran, Martin D.
Mesquita, João R.
author_role author
author2 Almeida-Santos, Madalena
Fernandes, Maria
Maltez, Fernando
Lino, Sara
Curran, Martin D.
Mesquita, João R.
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Nascimento, Maria S.J.
Almeida-Santos, Madalena
Fernandes, Maria
Maltez, Fernando
Lino, Sara
Curran, Martin D.
Mesquita, João R.
dc.subject.por.fl_str_mv Acute Disease
Autoimmune Diseases
Hepatitis E
Hepatitis E virus
Doença Aguda
Doenças Autoimunes
Hepatite E/imunologia
Vírus da Hepatite E
topic Acute Disease
Autoimmune Diseases
Hepatitis E
Hepatitis E virus
Doença Aguda
Doenças Autoimunes
Hepatite E/imunologia
Vírus da Hepatite E
description Hepatitis E virus genotype 3 infections are normally asymptomatic in immunocompetent individuals. Symptomatic cases of acute icteric hepatitis E are seldom observed among women, younger men and children but are particularly seen in middle-aged/elderly men. We report a case of severe acute hepatitis E caused by genotype 3 in an immunocompetent 40-year-old woman that required prolonged hospitalization. Her medical history included an autoimmune background, namely atrophic gastritis and Graves’ disease. She presented an extensive hepatic necrosis as revealed by the high levels of aminotransferases (ALT 4893 U/L; AST 3138 U/L). She showed also a coagulation disorder (prothrombin time; INR = 1.33). Serological markers for hepatitis viruses A, B and C were negative but serum was positive for hepatitis E virus RNA. Sequencing and phylogenetic analysis revealed that the hepatitis E virus strain belonged to subgenotype 3a. This is suggestive of an association between the severe acute hepatitis E virus genotype 3 infection and the autoimmune background.
publishDate 2020
dc.date.none.fl_str_mv 2020-06-01
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 33 No. 6 (2020): June; 425-428
Acta Médica Portuguesa; Vol. 33 N.º 6 (2020): Junho; 425-428
1646-0758
0870-399X
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