Fulminant hepatic failure in a patient with inactive HBsAg carrier state, acute hepatitis E and thyrotoxicosis.
A 38-year-old man presented with jaundice and significant weight loss. Investigations found positive hepatitis B surface antigen (HBsAg). His hepatitis B e antigen (HBeAg) was negative and HBV DNA was not detectable in the blood. Further tests revealed that he also had acute hepatitis E infection and uncontrolled thyrotoxicosis. The hypercatabolic state of coexisting thyrotoxicosis and acute hepatitis caused marked weight loss and clinical deterioration with fulminant hepatic failure. Institution of successful anti-thyroid treatment and supplemental nutrition effectively reversed the disease progression and the patient recovered fully.
Hui
Alex Yui
AY
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
Chan
Henry Lik Yuen
HL
Chan
Francis Ka Leung
FK
Leung
Nancy Wai Yee
NW
Sung
Joseph Jao Yiu
JJ