Fulminant Hepatic Failure Secondary to Herpes Hepatitis in a Patient With Myasthenia Crisis: An Elusive Diagnosis

Harish Patel, Hassan Tariq, Vinaya Gaduputi, Trupti Vakde, Jasbir Makker, Myrta Daniel

Abstract


Herpes hepatitis is a rare cause of fulminant hepatic failure contributing to less than 1% of all cases. It is most often seen in persons who are immunosuppressed and in pregnant women. The presentation is usually non-specific and rapidly progressive, thus making antemortem diagnosis of this condition rare. We present a patient who was on chronic immunosuppressive therapy for systemic lupus erythematosus and subsequently developed multi-organ failure with anicteric transaminitis as a result of disseminated herpes infection. The diagnosis was only made post-mortem. A confounding factor in this case was the fact that the patient underwent plasmapheresis, which skewed the interpretation of liver function tests in the setting of acute liver failure.




J Clin Med Res. 2016;8(12):921-924
doi: http://dx.doi.org/10.14740/jocmr2701w


Keywords


Herpes hepatitis; Anicteric hepatitis; Plasmapheresis; Transaminitis; Hepatic failure; Plasmapheresis and liver function tests

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