Hepatic failure due to fibrosing cholestatic hepatitis in a patient with pre-surface mutant hepatitis B virus and mixed connective tissue disease treated with prednisolone and chloroquine
Fibrosing cholestatic hepatitis (FCH) is a severe variant of hepatitis B infection that has until recently been described almost exclusively in the setting of organ transplantation and HIV infection. This case report describes a patient with pre-surface (pre-S) mutant hepatitis B virus (HBV) infecti...
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| Veröffentlicht in: | Journal of clinical virology 2004-09, Vol.31 (1), p.53-57 |
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| creator | Zanati, Simon A Locarnini, Stephen A Dowling, John P Angus, Peter W Dudley, Francis J Roberts, Stuart K |
| description | Fibrosing cholestatic hepatitis (FCH) is a severe variant of hepatitis B infection that has until recently been described almost exclusively in the setting of organ transplantation and HIV infection. This case report describes a patient with pre-surface (pre-S) mutant hepatitis B virus (HBV) infection who developed a fatal form of FCH after high dose prednisolone for mixed connective tissue disease (MCTD). The role of corticosteroids and pre-S viral mutation in the pathogenesis of the disease is discussed, and the importance of early diagnosis is emphasised. This report alerts the physician to the need for close monitoring of LFTs and HBV DNA of hepatitis B carriers during immunosuppressive therapy regardless of the indication. As in the transplantation setting, viral DNA levels should be kept to undetectable if viral replication or recurrence is to be prevented. |
| doi_str_mv | 10.1016/j.jcv.2004.02.013 |
| format | Article |
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This case report describes a patient with pre-surface (pre-S) mutant hepatitis B virus (HBV) infection who developed a fatal form of FCH after high dose prednisolone for mixed connective tissue disease (MCTD). The role of corticosteroids and pre-S viral mutation in the pathogenesis of the disease is discussed, and the importance of early diagnosis is emphasised. This report alerts the physician to the need for close monitoring of LFTs and HBV DNA of hepatitis B carriers during immunosuppressive therapy regardless of the indication. 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Psychology ; Hepatitis B - complications ; Hepatitis B - pathology ; Hepatitis B - virology ; Hepatitis B pre-S mutant ; Hepatitis B Surface Antigens - genetics ; Hepatitis B virus ; Hepatitis B virus - genetics ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunosuppression ; Infectious diseases ; Liver - pathology ; Liver Failure - etiology ; Medical sciences ; Microbiology ; Miscellaneous ; Mixed Connective Tissue Disease - complications ; Mixed Connective Tissue Disease - drug therapy ; Mutation ; Prednisolone ; Prednisolone - adverse effects ; Prednisolone - therapeutic use ; Viral diseases ; Viral hepatitis ; Virology</subject><ispartof>Journal of clinical virology, 2004-09, Vol.31 (1), p.53-57</ispartof><rights>2004 Elsevier B.V.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-c3e632c2764e04a4a6044de5c7a115023478beb791b20492073d5b8eaa14b5b33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcv.2004.02.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3541,27915,27916,45986</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16013581$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15288614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zanati, Simon A</creatorcontrib><creatorcontrib>Locarnini, Stephen A</creatorcontrib><creatorcontrib>Dowling, John P</creatorcontrib><creatorcontrib>Angus, Peter W</creatorcontrib><creatorcontrib>Dudley, Francis J</creatorcontrib><creatorcontrib>Roberts, Stuart K</creatorcontrib><title>Hepatic failure due to fibrosing cholestatic hepatitis in a patient with pre-surface mutant hepatitis B virus and mixed connective tissue disease treated with prednisolone and chloroquine</title><title>Journal of clinical virology</title><addtitle>J Clin Virol</addtitle><description>Fibrosing cholestatic hepatitis (FCH) is a severe variant of hepatitis B infection that has until recently been described almost exclusively in the setting of organ transplantation and HIV infection. This case report describes a patient with pre-surface (pre-S) mutant hepatitis B virus (HBV) infection who developed a fatal form of FCH after high dose prednisolone for mixed connective tissue disease (MCTD). The role of corticosteroids and pre-S viral mutation in the pathogenesis of the disease is discussed, and the importance of early diagnosis is emphasised. This report alerts the physician to the need for close monitoring of LFTs and HBV DNA of hepatitis B carriers during immunosuppressive therapy regardless of the indication. As in the transplantation setting, viral DNA levels should be kept to undetectable if viral replication or recurrence is to be prevented.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Chloroquine</subject><subject>Chloroquine - adverse effects</subject><subject>Chloroquine - therapeutic use</subject><subject>Cholestasis - etiology</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Fibrosing cholestatic hepatitis</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hepatitis B - complications</subject><subject>Hepatitis B - pathology</subject><subject>Hepatitis B - virology</subject><subject>Hepatitis B pre-S mutant</subject><subject>Hepatitis B Surface Antigens - genetics</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B virus - genetics</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Infectious diseases</subject><subject>Liver - pathology</subject><subject>Liver Failure - etiology</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Mixed Connective Tissue Disease - complications</subject><subject>Mixed Connective Tissue Disease - drug therapy</subject><subject>Mutation</subject><subject>Prednisolone</subject><subject>Prednisolone - adverse effects</subject><subject>Prednisolone - therapeutic use</subject><subject>Viral diseases</subject><subject>Viral hepatitis</subject><subject>Virology</subject><issn>1386-6532</issn><issn>1873-5967</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2O1DAQhCMEYpeFB-CCfIFbgn_jjDixK2CRVuICZ8uxO0yPMvZgOwM8Gy-H5wfNjZPd1tdVVlXTvGS0Y5T1bzfdxu07TqnsKO8oE4-aazZo0apVrx_Xuxj6tleCXzXPct5QypSQ-mlzxRQfhp7J6-bPPexsQUcmi_OSgPgFSIlkwjHFjOE7ces4Qy5HaH2EC2aCgVhyGCAU8hPLmuwStHlJk3VAtkux9f2C35I9piUTGzzZ4i_wxMUQwBXcVzvMubp6zGBzHRPYUol_qj5gjnMMcNx26zmm-GPBAM-bJ5OdM7w4nzfNt48fvt7dtw9fPn2-e__QOsloaZ2AXnDHdS-BSittT6X0oJy2jCnKayTDCKNesZFTueJUC6_GAaxlclSjEDfNm5Pu7mBcszBbzA7m2QaISzZMa66ZWlWQnUBXs8sJJrNLuLXpt2HUHBozG1MbM4fGDOWmNlZ3Xp3Fl3EL_rJxrqgCr8-Azc7OU7LBYb5wfVVRA6vcuxMHNYo9QjLZ1XYceEw1aOMj_ucbfwFD57go</recordid><startdate>20040901</startdate><enddate>20040901</enddate><creator>Zanati, Simon A</creator><creator>Locarnini, Stephen A</creator><creator>Dowling, John P</creator><creator>Angus, Peter W</creator><creator>Dudley, Francis J</creator><creator>Roberts, Stuart K</creator><general>Elsevier B.V</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20040901</creationdate><title>Hepatic failure due to fibrosing cholestatic hepatitis in a patient with pre-surface mutant hepatitis B virus and mixed connective tissue disease treated with prednisolone and chloroquine</title><author>Zanati, Simon A ; Locarnini, Stephen A ; Dowling, John P ; Angus, Peter W ; Dudley, Francis J ; Roberts, Stuart K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-c3e632c2764e04a4a6044de5c7a115023478beb791b20492073d5b8eaa14b5b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Chloroquine</topic><topic>Chloroquine - adverse effects</topic><topic>Chloroquine - therapeutic use</topic><topic>Cholestasis - etiology</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Fibrosing cholestatic hepatitis</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hepatitis B - complications</topic><topic>Hepatitis B - pathology</topic><topic>Hepatitis B - virology</topic><topic>Hepatitis B pre-S mutant</topic><topic>Hepatitis B Surface Antigens - genetics</topic><topic>Hepatitis B virus</topic><topic>Hepatitis B virus - genetics</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunosuppression</topic><topic>Infectious diseases</topic><topic>Liver - pathology</topic><topic>Liver Failure - etiology</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Mixed Connective Tissue Disease - complications</topic><topic>Mixed Connective Tissue Disease - drug therapy</topic><topic>Mutation</topic><topic>Prednisolone</topic><topic>Prednisolone - adverse effects</topic><topic>Prednisolone - therapeutic use</topic><topic>Viral diseases</topic><topic>Viral hepatitis</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zanati, Simon A</creatorcontrib><creatorcontrib>Locarnini, Stephen A</creatorcontrib><creatorcontrib>Dowling, John P</creatorcontrib><creatorcontrib>Angus, Peter W</creatorcontrib><creatorcontrib>Dudley, Francis J</creatorcontrib><creatorcontrib>Roberts, Stuart K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Journal of clinical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zanati, Simon A</au><au>Locarnini, Stephen A</au><au>Dowling, John P</au><au>Angus, Peter W</au><au>Dudley, Francis J</au><au>Roberts, Stuart K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatic failure due to fibrosing cholestatic hepatitis in a patient with pre-surface mutant hepatitis B virus and mixed connective tissue disease treated with prednisolone and chloroquine</atitle><jtitle>Journal of clinical virology</jtitle><addtitle>J Clin Virol</addtitle><date>2004-09-01</date><risdate>2004</risdate><volume>31</volume><issue>1</issue><spage>53</spage><epage>57</epage><pages>53-57</pages><issn>1386-6532</issn><eissn>1873-5967</eissn><abstract>Fibrosing cholestatic hepatitis (FCH) is a severe variant of hepatitis B infection that has until recently been described almost exclusively in the setting of organ transplantation and HIV infection. This case report describes a patient with pre-surface (pre-S) mutant hepatitis B virus (HBV) infection who developed a fatal form of FCH after high dose prednisolone for mixed connective tissue disease (MCTD). The role of corticosteroids and pre-S viral mutation in the pathogenesis of the disease is discussed, and the importance of early diagnosis is emphasised. This report alerts the physician to the need for close monitoring of LFTs and HBV DNA of hepatitis B carriers during immunosuppressive therapy regardless of the indication. As in the transplantation setting, viral DNA levels should be kept to undetectable if viral replication or recurrence is to be prevented.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>15288614</pmid><doi>10.1016/j.jcv.2004.02.013</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Chloroquine Chloroquine - adverse effects Chloroquine - therapeutic use Cholestasis - etiology Fatal Outcome Female Fibrosing cholestatic hepatitis Fundamental and applied biological sciences. Psychology Hepatitis B - complications Hepatitis B - pathology Hepatitis B - virology Hepatitis B pre-S mutant Hepatitis B Surface Antigens - genetics Hepatitis B virus Hepatitis B virus - genetics Human immunodeficiency virus Human viral diseases Humans Immunosuppression Infectious diseases Liver - pathology Liver Failure - etiology Medical sciences Microbiology Miscellaneous Mixed Connective Tissue Disease - complications Mixed Connective Tissue Disease - drug therapy Mutation Prednisolone Prednisolone - adverse effects Prednisolone - therapeutic use Viral diseases Viral hepatitis Virology |
| title | Hepatic failure due to fibrosing cholestatic hepatitis in a patient with pre-surface mutant hepatitis B virus and mixed connective tissue disease treated with prednisolone and chloroquine |
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