title: [A case of hepatitis E differentially diagnosed from drug-induced liver injury].
abstract: A woman in her seventies was admitted because of general fatigue and liver dysfunction (ALT 2565 IU/l). She was diabetic and, 2 months ago, began eating kikuimo (Jerusalem artichoke) containing inulin, which is thought to decrease blood sugar level. Although tests showed no evidence of acute infection of HAV, HBV, HCV, EBV and CMV, a drug-induced lymphocyte stimulation test using kikuimo extract was positive. She was first diagnosed with drug-induced liver injury according to the Japanese diagnostic criteria for the disease. After a non-eventful recovery, her serum was found to be positive for hepatitis E-antibody and RNA (genotype 3), indicating recent, autochthonous infection of HEV. The patient might have been misdiagnosed with drug-induced liver injury unless the serum test for HEV had been performed. We believe that HEV screening is mandatory for accurate diagnosis of hepatitis E and drug-induced liver injury.
authors.affiliation: Department of Gastroenterology, National Hospital Organization, Takasaki General Center Hospital.
authors.forename: Sho
authors.initials: S
authors.lastname: Ishiwata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hoshino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Naganuma
authors.forename: Naomi
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Eri
authors.initials: E
authors.lastname: Koitabashi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Souma
authors.forename: Masayuki
authors.initials: M
authors.lastname: Inui
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kudo
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tahara
authors.forename: Mieko
authors.initials: M
authors.lastname: Kaneko
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okamoto
mesh_terms: D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D016751:Hepatitis E / Q000175:diagnosis*; D006801:Humans; D012367:RNA, Viral / Q000032:analysis; D012698:Serologic Tests
chemical_list: D012367:RNA, Viral