Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis
Acute hepatitis E is becoming increasingly recognised in Europe with up to 40% of the population in Southern France being exposed to the virus, which is harboured in pigs. Patients with known liver disease may present with acute hepatitis E and present a diagnostic challenge. For example patients wi...
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doaj-f58fa614c1f24d65a8e130df253fafe32021-06-09T05:51:08ZengElsevierAnnals of Hepatology1665-26812017-01-01161160163Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune HepatitisGiorgio Calisti0Dianne N Irish1Samreen Ijaz2Richard S Tedder3Kevin Moore4Department of Virology, Royal Free London NHS Foundation Trust, London, United Kingdom; Correspondence and reprint request:Department of Virology, Royal Free London NHS Foundation Trust, London, United KingdomBlood Borne Virus Unit, MS-Colindale, Public Health England, London, United KingdomBlood Borne Virus Unit, MS-Colindale, Public Health England, London, United KingdomCentre for Hepatology, Royal Free and University College Medical School, University CollegeLondon, United KingdomAcute hepatitis E is becoming increasingly recognised in Europe with up to 40% of the population in Southern France being exposed to the virus, which is harboured in pigs. Patients with known liver disease may present with acute hepatitis E and present a diagnostic challenge. For example patients with autoimmune hepatitis (AIH) who are immunosuppressed and contract hepatitis E may be at increased risk of developing chronicity due to concurrent immunosuppression. Importantly, the diagnosis may be missed with the infection misdiagnosed as an autoimmune flare, and immunosuppression increased by the attending physician, thus enhancing the risk of chronicity of infection leading to progressive liver injury in immunocompromised patients.We report a case of acute hepatitis E in a patient with AIH and discuss the features that helped us differentiating it from an autoimmune flare.http://www.sciencedirect.com/science/article/pii/S1665268119303746Hepatitis EHEVAutoimmune hepatitisAIHImmunosuppression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giorgio Calisti Dianne N Irish Samreen Ijaz Richard S Tedder Kevin Moore |
spellingShingle |
Giorgio Calisti Dianne N Irish Samreen Ijaz Richard S Tedder Kevin Moore Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis Annals of Hepatology Hepatitis E HEV Autoimmune hepatitis AIH Immunosuppression |
author_facet |
Giorgio Calisti Dianne N Irish Samreen Ijaz Richard S Tedder Kevin Moore |
author_sort |
Giorgio Calisti |
title |
Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis |
title_short |
Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis |
title_full |
Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis |
title_fullStr |
Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis |
title_full_unstemmed |
Acute Hepatitis E Mimicking a Flare of Disease in a Patient with Chronic Autoimmune Hepatitis |
title_sort |
acute hepatitis e mimicking a flare of disease in a patient with chronic autoimmune hepatitis |
publisher |
Elsevier |
series |
Annals of Hepatology |
issn |
1665-2681 |
publishDate |
2017-01-01 |
description |
Acute hepatitis E is becoming increasingly recognised in Europe with up to 40% of the population in Southern France being exposed to the virus, which is harboured in pigs. Patients with known liver disease may present with acute hepatitis E and present a diagnostic challenge. For example patients with autoimmune hepatitis (AIH) who are immunosuppressed and contract hepatitis E may be at increased risk of developing chronicity due to concurrent immunosuppression. Importantly, the diagnosis may be missed with the infection misdiagnosed as an autoimmune flare, and immunosuppression increased by the attending physician, thus enhancing the risk of chronicity of infection leading to progressive liver injury in immunocompromised patients.We report a case of acute hepatitis E in a patient with AIH and discuss the features that helped us differentiating it from an autoimmune flare. |
topic |
Hepatitis E HEV Autoimmune hepatitis AIH Immunosuppression |
url |
http://www.sciencedirect.com/science/article/pii/S1665268119303746 |
work_keys_str_mv |
AT giorgiocalisti acutehepatitisemimickingaflareofdiseaseinapatientwithchronicautoimmunehepatitis AT diannenirish acutehepatitisemimickingaflareofdiseaseinapatientwithchronicautoimmunehepatitis AT samreenijaz acutehepatitisemimickingaflareofdiseaseinapatientwithchronicautoimmunehepatitis AT richardstedder acutehepatitisemimickingaflareofdiseaseinapatientwithchronicautoimmunehepatitis AT kevinmoore acutehepatitisemimickingaflareofdiseaseinapatientwithchronicautoimmunehepatitis |
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1721389111256809472 |