Ischaemic hepatitis in an elderly woman.
An elderly woman presented with very high levels of transaminases and lactic dehydrogenase in her liver function tests. Viral and drug-induced hepatitis were considered unlikely because of the absence of risk factors. Sepsis was suspected and antibiotic treatment was started with clinical improvement. A retrospective diagnosis of ischaemic hepatitis due to septicaemia was made. Markedly raised liver transaminases need not always be drug-induced or viral-related, especially in the elderly. It could be ischaemic in origin and the serious underlying condition needs to be sought and treated urgently.
Lim
J K
JK
Department of Geriatric Medicine, Alexandra Hospital, Singapore.
Yap
K B
KB
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D016470:Bacteremia / Q000382:microbiology; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006505:Hepatitis / Q000382:microbiology*; D006801:Humans; D007511:Ischemia / Q000382:microbiology*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000098:blood supply* / Q000201:enzymology; D018805:Sepsis / Q000175:diagnosis*; D013203:Staphylococcal Infections / Q000175:diagnosis*
D002511:Cephalosporins; D002443:Ceftriaxone; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase