Hepatitis viruses causing pancreatitis and hepatitis: a case series and review of literature.
OBJECTIVE
Association between acute pancreatitis and acute viral hepatitis (AVH) is more frequent than previously thought. Most cases are hepatitis A or B virus related. Only 6 cases of acute pancreatitis with acute hepatitis E virus (HEV)-related hepatitis has been reported so far.


METHODS
We analyzed the hospital records of 334 patients of acute pancreatitis admitted from December 2004 to March 2006. Seven patients had an associated AVH.


RESULTS
Of these, 4 had HEV-related and 3 had hepatitis A virus-related AVH. All but one were young males who presented with abdominal pain during the second to third week of hepatitis illness. None had a history of biliary colic, alcoholism, abdominal trauma, or intake of drugs causing pancreatitis or a family history of pancreatitis. Mean bilirubin was 10.74 mg/dL; alanine aminotransferase levels, 482.85 IU/L; and serum amylase, 1263.57 IU/L. All patients had an imaging evidence of pancreatitis. Two patients with HEV-related disease had grades D to E pancreatitis. All were managed conservatively and recovered completely.


CONCLUSIONS
Association between acute pancreatitis and nonfulminant viral hepatitis is now more frequently recognized. Seen more commonly in young males during the second and third week of hepatitis illness, HEV might be associated with severe pancreatitis.
Bhagat
Sandeep
S
Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
Wadhawan
Manav
M
Sud
Randhir
R
Arora
Anil
A
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005260:Female; D006506:Hepatitis A / Q000150:complications; D030041:Hepatitis A virus / Q000302:isolation & purification*; D016751:Hepatitis E / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000821:virology*; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000150:complications / Q000821:virology*
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin