title: Hepatitis A-induced diabetes mellitus, acute renal failure, and liver failure.
abstract: A 38-year-old otherwise healthy man presented with hepatic failure (aspartate aminotransferase of 7212 U/L, alanine aminotransferase of 6629 U/L, total and direct bilirubin of 10.7 mg/dL) and acute renal failure (creatinine of 11.6 mg/dL and blood urea nitrogen of 42 mg/dL), which required hemodialysis when the creatinine increased to 21 mg/dL, with a blood urea nitrogen of 115 mg/dL, and the patient became oliguric. On admission, this patient also had a lipase of 1833 U/L, amylase of 211 U/L, glucose of 210 mg/dL, and reactive IgM antibody for acute hepatitis A. The hepatitis and acute renal failure resolved in 3 months, but this patient continues to have type II diabetes mellitus 7 years after the hepatitis A infection. This case illustrates that hepatitis A infection may be severe with liver failure, acute renal failure, and permanent diabetes mellitus as sequale of this infection.
authors.affiliation: Department of Internal Medicine at the University of South Florida for Health Sciences and James A. Haley Veterans Hospital, Tampa, 33612, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Vesely
authors.forename: R W
authors.initials: RW
authors.lastname: Dilley
authors.forename: W C
authors.initials: WC
authors.lastname: Duckworth
authors.forename: F F
authors.initials: FF
authors.lastname: Paustian
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000821:virology*; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000821:virology*; D004196:Disease Outbreaks; D005431:Florida / Q000453:epidemiology; D006506:Hepatitis A / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000821:virology*; D008297:Male