title: Hepatitis A virus-related late-onset hepatic failure: a case report.
abstract: Late-onset hepatic failure, the least of the fulminant hepatic failures, has not occurred in patients with hepatitis A virus-related acute liver failure. We report a rare case of hepatitis A virus-related late-onset hepatic failure treated successfully by an emergent liver transplant. A 58-year-old Japanese woman who presented with fever and general malaise was diagnosed as having jaundice and liver dysfunction by a positive serum test for anti-hepatitis A virus IgM, which ultimately led to a diagnosis of acute hepatitis A virus associated hepatitis. Despite intensive treatment, her general condition was poor, and she developed a hepatic coma 79 days from the onset of the disease. Under a diagnosis of hepatitis A virus-related late onset hepatic failure, she was given a living-donor liver transplant 82 days from the start of the disease. The resected native liver revealed submassive necrosis with marked cholestasis, compatible with late-onset hepatic failure. Today, 5 years after the transplant, she is alive and well with no signs of recurrent hepatitis A virus-hepatitis. This case should alert the physician to the clinical management of a patient with hepatitis A virus-related acute liver failure.
authors: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan. sur083@poh.osaka-med.ac.jp
authors: Michihiro
authors: M
authors: Hayashi
authors: Tetsunosuke
authors: T
authors: Shimizu
authors: Ichiro
authors: I
authors: Tsunematsu
authors: Fumitoshi
authors: F
authors: Hirokawa
authors: Mitsuhiro
authors: M
authors: Asakuma
authors: Atsushi
authors: A
authors: Takeshita
authors: Hironori
authors: H
authors: Haga
authors: Nobuhiko
authors: N
authors: Tanigawa
mesh_terms: D005260:Female; D006506:Hepatitis A / Q000150:complications* / Q000175:diagnosis; D030041:Hepatitis A virus / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology*; D017114:Liver Failure, Acute / Q000601:surgery / Q000821:virology*; D016031:Liver Transplantation; D008875:Middle Aged; D016896:Treatment Outcome