Acute liver failure in pregnancy. A case report.
BACKGROUND
Liver disease in pregnancy can be grossly divided into those disorders coincidentally occurring during the pregnant state and hepatic diseases limited to pregnancy. Numerous infectious agents can result in acute hepatitis and include not only the hepatitis viruses--A, B, C and E--but herpesvirus and cytomegalovirus as well. Coxsackie B viruses can cause several clinical presentations, ranging from asymptomatic to mild febrile illness to myocarditis and meningitis. Rarely has coxsackievirus infection been associated with fulminant hepatic failure.


METHODS
A Coxsackie B virus infection resulted in acute liver failure in a gravid woman. The patient was managed expectantly, with resolution of the liver disease and delivery five weeks after discharge.


CONCLUSIONS
The onset of hepatic disease is insidious, with only vague symptoms or minor complaints often heralding the progression to liver failure. A careful history, physical examination and appropriate diagnostic tests can help determine the etiology of hepatic disease and help decide whether expectant management of the gravid patient or immediate delivery is appropriate.
Department of Obstetrics and Gynecology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA.
J S
JS
Archer
D000208:Acute Disease; D000328:Adult; D003384:Coxsackievirus Infections / Q000175:diagnosis*; D029822:Enterovirus B, Human; D005260:Female; D006525:Hepatitis, Viral, Human / Q000175:diagnosis*; D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications / Q000821:virology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000821:virology*