Fulminant Hepatic Failure Secondary to Herpes Hepatitis in a Patient With Myasthenia Crisis: An Elusive Diagnosis.
Herpes hepatitis is a rare cause of fulminant hepatic failure contributing to less than 1% of all cases. It is most often seen in persons who are immunosuppressed and in pregnant women. The presentation is usually non-specific and rapidly progressive, thus making antemortem diagnosis of this condition rare. We present a patient who was on chronic immunosuppressive therapy for systemic lupus erythematosus and subsequently developed multi-organ failure with anicteric transaminitis as a result of disseminated herpes infection. The diagnosis was only made post-mortem. A confounding factor in this case was the fact that the patient underwent plasmapheresis, which skewed the interpretation of liver function tests in the setting of acute liver failure.
Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USA.
Harish
H
Patel
Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USA.
Hassan
H
Tariq
Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USA.
Vinaya
V
Gaduputi
Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USA.
Trupti
T
Vakde
Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USA.
Jasbir
J
Makker
Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USA.
Myrta
M
Daniel
Anicteric hepatitis; Hepatic failure; Herpes hepatitis; Plasmapheresis; Plasmapheresis and liver function tests; Transaminitis