Hepatitis A virus-related late-onset hepatic failure: a case report

Exp Clin Transplant. 2011 Apr;9(2):150-2.

Abstract

Late-onset hepatic failure, the least of the fulminant hepatic failures, has not occurred in patients with hepatitis A virus-related acute liver failure. We report a rare case of hepatitis A virus-related late-onset hepatic failure treated successfully by an emergent liver transplant. A 58-year-old Japanese woman who presented with fever and general malaise was diagnosed as having jaundice and liver dysfunction by a positive serum test for anti-hepatitis A virus IgM, which ultimately led to a diagnosis of acute hepatitis A virus associated hepatitis. Despite intensive treatment, her general condition was poor, and she developed a hepatic coma 79 days from the onset of the disease. Under a diagnosis of hepatitis A virus-related late onset hepatic failure, she was given a living-donor liver transplant 82 days from the start of the disease. The resected native liver revealed submassive necrosis with marked cholestasis, compatible with late-onset hepatic failure. Today, 5 years after the transplant, she is alive and well with no signs of recurrent hepatitis A virus-hepatitis. This case should alert the physician to the clinical management of a patient with hepatitis A virus-related acute liver failure.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Female
  • Hepatitis A / complications*
  • Hepatitis A / diagnosis
  • Hepatitis A virus / isolation & purification*
  • Humans
  • Liver / pathology
  • Liver / virology*
  • Liver Failure, Acute / surgery
  • Liver Failure, Acute / virology*
  • Liver Transplantation
  • Middle Aged
  • Treatment Outcome