Severe Acute Hepatitis E in a Woman with an Autoimmune Background

Authors

  • Maria S.J. Nascimento Laboratório de Microbiologia. Departamento de Ciências Biológicas. Faculdade de Farmácia. Universidade do Porto. Porto. Epidemiology Research Unit. Instituto de Saúde Pública. Universidade do Porto. Porto. https://orcid.org/0000-0002-6157-4978
  • Madalena Almeida-Santos Laboratório de Patologia Clínica. Hospital Curry Cabral. Centro Hospitalar Lisboa Central. Lisboa.
  • Maria Fernandes Laboratório de Patologia Clínica. Hospital Curry Cabral. Centro Hospitalar Lisboa Central. Lisboa.
  • Fernando Maltez Serviço de Doenças Infeciosas. Hospital Curry Cabral. Centro Hospitalar Lisboa Central. Lisboa.
  • Sara Lino Serviço de Doenças Infeciosas. Hospital Curry Cabral. Centro Hospitalar Lisboa Central. Lisboa.
  • Martin D. Curran Clinical Microbiology and Public Health Laboratory. Addenbrooke´s Hospital. Cambridge.
  • João R. Mesquita Epidemiology Research Unit. Instituto de Saúde Pública. Universidade do Porto. Porto. Instituto de Ciências Biomédicas de Abel Salazar. Universidade do Porto. Porto.

DOI:

https://doi.org/10.20344/amp.10429

Keywords:

Acute Disease, Autoimmune Diseases, Hepatitis E, Hepatitis E virus

Abstract

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.

Downloads

Download data is not yet available.

Author Biography

Maria S.J. Nascimento, Laboratório de Microbiologia. Departamento de Ciências Biológicas. Faculdade de Farmácia. Universidade do Porto. Porto. Epidemiology Research Unit. Instituto de Saúde Pública. Universidade do Porto. Porto.

PhD, Agregation, Full Professor

Downloads

Published

2020-06-01

How to Cite

1.
Nascimento MS, Almeida-Santos M, Fernandes M, Maltez F, Lino S, Curran MD, Mesquita JR. Severe Acute Hepatitis E in a Woman with an Autoimmune Background. Acta Med Port [Internet]. 2020 Jun. 1 [cited 2024 Feb. 27];33(6):425-8. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/10429

Issue

Section

Case Report