title: Severe exacerbation of hepatitis after short-term corticosteroid therapy in a patients with "latent" chronic hepatitis B.
abstract: We present a case of severe exacerbation of hepatitis after short-term corticosteroid therapy for chronic inflammatory demyelinating polyneuropathy (CIPD) with "latent" chronic hepatitis B showing no HBV-related antigens and antibodies. After corticosteroid pulse therapy for CIPD, the patient had severe exacerbation of hepatitis twice. Although she did not show any hepatitis B virus (HBV)-related antigens or antibodies, sequences of HBV were detected in serum and liver by a nested polymerase chain reaction. A sequence analysis of HBV at the second exacerbation showed that the G-to-A point mutation at nucleotide 1896 that converted codon 28 from tryptophan (TGG) to a stop codon (TAG) in the precore region resulted in amino acid change, which has been frequently observed in fulminant hepatitis and severe hepatitis in Japan.
authors.affiliation: Second Department of Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: G
authors.initials: G
authors.lastname: Shiota
authors.forename: K
authors.initials: K
authors.lastname: Harada
authors.forename: K
authors.initials: K
authors.lastname: Oyama
authors.forename: A
authors.initials: A
authors.lastname: Udagawa
authors.forename: T
authors.initials: T
authors.lastname: Nomi
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: A
authors.initials: A
authors.lastname: Tsutsumi
authors.forename: N
authors.initials: N
authors.lastname: Noguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Horie
authors.forename: T
authors.initials: T
authors.lastname: Suou
authors.forename: H
authors.initials: H
authors.lastname: Kawasaki
mesh_terms: D000305:Adrenal Cortex Hormones / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000954:Antigens, Surface / Q000097:blood / Q000276:immunology; D001483:Base Sequence; D001706:Biopsy; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000473:pathology* / Q000821:virology; D006651:Histocytochemistry; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000473:pathology / Q000821:virology; D008969:Molecular Sequence Data; D017354:Point Mutation / Q000235:genetics; D016133:Polymerase Chain Reaction; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000150:complications* / Q000188:drug therapy*; D017422:Sequence Analysis, DNA; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000954:Antigens, Surface; D004279:DNA, Viral