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Case Reports
. 2017:2017:3180984.
doi: 10.1155/2017/3180984. Epub 2017 Aug 1.

Herpes Simplex Virus Hepatitis: A Presentation of Multi-Institutional Cases to Promote Early Diagnosis and Management of the Disease

Ashwinee Natu  1 , Guiseppe Iuppa  2 , Clifford D Packer  3
Affiliations
Case Reports

Herpes Simplex Virus Hepatitis: A Presentation of Multi-Institutional Cases to Promote Early Diagnosis and Management of the Disease

Ashwinee Natu et al. Case Reports Hepatol. 2017.

Abstract

Objective: To compare three cases of Herpes simplex virus (HSV) hepatitis to increase early diagnosis of the disease. Case 1. A 23-year-old man with Crohn's disease and oral HSV. HSV hepatitis was diagnosed clinically and he improved with acyclovir. Case 2. An 18-year-old G1P0 woman with transaminitis. Despite early empiric acyclovir therapy, she died due to fulminant liver failure. Case 3. A 65-year-old woman who developed transaminitis after liver transplant. Diagnosis was confirmed by biopsy and she had resolution of acute liver failure with acyclovir.

Conclusion: It is imperative that clinicians be aware of patients at high risk for developing HSV hepatitis to increase timely diagnosis and prevent morbidity and fatality.

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Figures

Figure 1
Figure 1
Case #1 trend in ALT and AST. ALT: alanine aminotransferase; AST: aspartate aminotransferase.
Figure 2
Figure 2
Case #1 trend in Total Bilirubin and INR. T. Bili: Total Bilirubin; INR: International Randomized Ratio.
Figure 3
Figure 3
Case #2 trend in AST and ALT. ALT: alanine aminotransferase; AST: aspartate aminotransferase.
Figure 4
Figure 4
Case #2 trend in Total Bilirubin and INR. T. Bili: Total Bilirubin; INR: International Randomized Ratio.
Figure 5
Figure 5
Case #3 trend in AST and ALT. ALT: alanine aminotransferase; AST: aspartate aminotransferase.
Figure 6
Figure 6
Case #3 trend in Total Bilirubin and INR. T. Bili: Total Bilirubin; INR: International Randomized Ratio.
Figure 7
Figure 7
Liver biopsy from patient 3 showing intranuclear viral inclusions within the necrotic areas.
Figure 8
Figure 8
HSV immunostain from liver biopsy (patient 3).
See this image and copyright information in PMC

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