A case of acute viral hepatitis interfering with acute fatty liver disease of pregnancy

Abstract

Acute hepatitis A is a rarely seen infection during preg­nancy. In terms of clinical and laboratory findings, it can be interfere with acute fatty liver disease which can be quite mortal during pregnancy. Since liver function tests are el­evated in both conditions, hepatitis A infection should also be kept in mind in differential diagnosis. We present a 30 year-old pregnant woman with 35 weeks of gestation who presented to our clinic with a suspection of acute fatty liver disease but finally diagnosed as acute hepatitis A in­fection. J Clin Exp Invest 2013; 4 (1): 123-125

Keywords

• Hepatitis A, pregnancy, acute fatty liver dis­ease

Gebeliğin akut yağlı karaciğer hastalığı ile karışan akut viral Hepatit A olgusu

Öz

Gebelikte akut hepatit A enfeksiyonu oldukça nadir görül­mektedir. Klinik ve laboratuar bulgularıyla gebelikte olduk­ça mortal seyredebilen gebeliğin akut yağlı karaciğer has­talığı ile karışabilmektedir. Karaciğer fonksiyon testlerinde yükseklik izlenen her iki durumun ayırıcı tanısı yapılmalı ve bu tabloyla gelen bir hastada hepatit A enfeksiyonu da akla gelmelidir. Kliniğimize başvurusunda, gebeliğin akut yağlı karaciğer hastalığı tanısı sonrasında akut hepatit A tanısı alan, 30 yaşında 35 haftalık gebeliği olan bir olgu sunulmuştur.

Anahtar Kelimeler

• Hepatit A, gebelik, akut yağlı karaci­ğer hastalığı

References

1. Jaiswal SP, Jain AK, Naik G, et al. Viral hepatitis during pregnancy. Int J Gynaecol Obstet 2001;72:103-108.
2. Bernuau J, Nicand E, Durand F. Hepatitis E-associat- ed acute liver failure in pregnancy: an Indian puzzle. Hepatology 2008;48:1380-1382.
3. Cunningham FG, Leveno KJ, Bloom SL, et al. Kara- ciğer, safra yolları ve pankreas hastalıkları. Williams Obstetrics, 23th ed, New York, McGraw-Hill, 2009, Türkçe çevirisi 1067-1073.
4. Wheeler C, Vogt TM, Armstrong GL, et al. An outbreak of hepatitis A associated with green onions. N Engl J Med 2005;353:890-897.
5. Simsek Y, Isik B, Karaer A, et al. Fulminant hepatitis A infection in second trimester of pregnancy requiring living-donor liver transplantation. J Obstet Gynaecol Res 2012;38:745-748.
6. Elinav E, Ben-Dov IZ, Shapira Y, et al. Acute hepatitis A infection in pregnancy is associated with high rates of gestational complications and preterm labor. Gastro- enterology 2006;130:1129-1134.
7. Lee WM. Etiologies of acute liver failure. Semin Liver Dis 2008;28:142-152.
8. Castro MA, Goodwin TM, Shaw KJ, et al. Disseminated intravascular coagulation and antithrombin III depres- sion in acute fatty liver of pregnancy. Am J Obstet Gy- necol 1996;174:211-216.

9. Castro MA, Fassett MJ, Reynolds TB, et al. Revers- ible peripartum liver failure: a new perspective on the diagnosis, treatment, and cause of acute fatty liver of pregnancy, based on 28 consecutive cases. Am J Ob- stet Gynecol 1999;181:389-395.
10. Ockner SA, Brunt EM, Cohn SM, et al. Fulminant he- patic failure caused by acute fatty liver of pregnancy treated by orthotopic liver transplantation. Hepatology 1990;11:59-64.