title: Fulminant hepatitis E in a woman taking oral contraceptive medication.
abstract: We describe a fulminant autochthonous hepatic failure caused by hepatitis E (HEV) in a patient admitted in our hospital for liver-transplant evaluation. The only risk factor recorded for this severe course was the use of oral contraceptives that are known to mimic a hormonal status similar to pregnancy. The diagnosis was based on the presence of IgG and IgM anti-HEV in the serum of the patient and confirmed by the isolation of a strain of HEV genotype 3f from a blood sample obtained the fourth day after hospital admission. HEV genotype 3 is present in human and swine populations in Spain. The patient began to recover while waiting for a liver transplant. To our knowledge, this is the first report of fulminant hepatitis E in a non-pregnant European patient on oral contraceptives.
authors.affiliation: Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. mmateos.hrc@salud.madrid.org
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Mateos Lindemann
authors.forename: Javier Graus
authors.initials: JG
authors.lastname: Morales
authors.forename: Salceda
authors.initials: S
authors.lastname: Fernández-Barredo
authors.forename: Mario Rodríguez
authors.initials: MR
authors.lastname: Domínguez
authors.forename: Fernando
authors.initials: F
authors.lastname: García de la Hoz
authors.forename: Philippe
authors.initials: P
authors.lastname: Halfon
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pérez Gracia
mesh_terms: D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D005260:Female; D005838:Genotype; D016751:Hepatitis E / Q000175:diagnosis* / Q000503:physiopathology; D016752:Hepatitis E virus / Q000145:classification / Q000235:genetics; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000503:physiopathology; D010802:Phylogeny; D012720:Severity of Illness Index
chemical_list: D003278:Contraceptives, Oral, Hormonal