Acute viral hepatitis is usually a self-limiting illness.However,it can lead to complications that can be life-threatening,such as acute liver failure.Glucose 6 phosphate dehydrogenase (G6PD) deficiency in the setting...Acute viral hepatitis is usually a self-limiting illness.However,it can lead to complications that can be life-threatening,such as acute liver failure.Glucose 6 phosphate dehydrogenase (G6PD) deficiency in the setting of acute viral hepatitis can lead to a massive hemolysis,manifesting as acute kidney injury and markedly raised bilirubin levels;although cases are rare.Here,we report such a case.The patient had a viral hepatitis E infection and presented with kidney injury requiring dialysis.Examination showed very high mixed hyperbilirubinemia due to massive intravascular hemolysis.The patient experienced a long,protracted course of illness,requiring renal replacement therapy with other supportive management,which led to improvement over a period of four weeks.This case highlights the importance of recognizing associated hemolysis in a patient with viral hepatitis who presents with very high bilirubin levels or associated kidney injury.Such patients will require aggressive supportive care with prompt fluid and electrolyte management.展开更多
文摘Acute viral hepatitis is usually a self-limiting illness.However,it can lead to complications that can be life-threatening,such as acute liver failure.Glucose 6 phosphate dehydrogenase (G6PD) deficiency in the setting of acute viral hepatitis can lead to a massive hemolysis,manifesting as acute kidney injury and markedly raised bilirubin levels;although cases are rare.Here,we report such a case.The patient had a viral hepatitis E infection and presented with kidney injury requiring dialysis.Examination showed very high mixed hyperbilirubinemia due to massive intravascular hemolysis.The patient experienced a long,protracted course of illness,requiring renal replacement therapy with other supportive management,which led to improvement over a period of four weeks.This case highlights the importance of recognizing associated hemolysis in a patient with viral hepatitis who presents with very high bilirubin levels or associated kidney injury.Such patients will require aggressive supportive care with prompt fluid and electrolyte management.
