Spontaneous Resolution of Brain Edema in Fulminant Hepatic Failure due to Hepatitis E

Abstract

Fulminant hepatic failure is characterized by the presence of hepatic encephalopathy in the setting of acute liver injury that occurs in a noncirrhotic organ. Brain edema is the ultimate complication of advanced hepatic encephalopathy as it often leads to cerebral herniation and death. Thus, the presence of fulminant hepatic failure indicates the need for urgent liver transplantation to prevent death or irreversible brain damage. We report a very unusual evolution of fulminant hepatic failure complicated by brain edema and hepatic coma in a 45-year-old woman admitted with acute viral hepatitis E infection.

Keywords: Brain edema; Fulminant hepatic failure; Hepatic encephalopathy; Hepatitis E; Liver transplantation.

Fig. 1

Evolution of laboratory values over time since hospital admission in Geneva.