Summary
We are reporting a fatal case of acute Non-A, Non-B (NANB) hepatitis with massive liver destruction in a 58-year-old woman. NANB hepatitis is still a diagnosis by exclusion, and detailed knowledge of the endemic diseases associated with hepatitis in a given geographic area should be included in the diagnostic work-up. In Lebanon, where 97% of the adult population has anti-HAV in their sera, the IgM fraction of anti-HAV must be determined in order to differentiate between previous exposure to HAV and an active infection. Q fever, an endemic disease in this area, should be also ruled out before the diagnosis of NANB hepatitis is established.
Zusammenfassung
Wir berichten über einen Fall von Nicht-A-, Nicht-B-(NANB-) Hepatitis mit tödlichem Ausgang bei massiver Lebergewebszerstörung bei einer 58 Jahre alten Frau. Die Diagnose der NANB-Hepatitis wird immer nochper exclusionem gestellt. Bei der diagnostischen Aufarbeitung sollte die endemische Situation einer bestimmten geographischen Region bezüglich Hepatitis-assoziierten Infektionen aus Krankheiten einbezogen werden. Im Libanon enthalten 97% der Seren der erwachsenen Bevölkerung anti-HAV; daher ist es erforderlich, die IgM-Fraktion von anti-HAV zu bestimmen, um zwischen früherer Exposition gegenüber HAV und einer aktiven Infektion unterscheiden zu können. Auch das Q-Fieber, das in dieser Region endemisch auftritt, sollte ausgeschlossen werden, bevor die Diagnose einer NANB-Hepatitis gestellt wird.
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Shamma'a, M., Feghali, S. & Allam, C. Fatal, acute Non-A, Non-B hepatitis with confluent necrosis. Case report and proposal for diagnostic work-up. Infection 10, 165–167 (1982). https://doi.org/10.1007/BF01640768
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DOI: https://doi.org/10.1007/BF01640768