Fulminant hepatitis B: A case report

Abstract

Introduction: Fulminant hepatitis is a severe acute liver disease. It occurs due to massive necrosis of hepatocytes. The disease progresses to lethal outcome within a few days. The most common causes of this disease are toxic substances, autoimmune and viral hepatitis. The aim of the study was to present a lethal case of fulminant hepatitis caused by hepatitis B virus in a patient with treated bladder cancer. Case Outline: A 63-year-old patient was admitted for treatment due to weakness, nausea and decreased diuresis. She had surgery to remove her bladder, which was affected by a malignant process, two years earlier. On admission, she had a subicteric, orderly auscultatory finding. The abdomen was palpably painful below the right costal arch, without organomegaly. The ureterostomy was functional. The diagnosis of acute HBV infection was made by evidence of HBsAg, HBeAg and antiHBc IgM antibody titer. Laboratory findings indicated an increase in transaminases, urea, creatinine, total and conjugated bilirubin, decreased albumin values and coagulation disorders. The patient was treated with hepatoprotective therapy, antibiotics and antiviral therapy. Hemodialysis was performed as needed. Encephalopathy developed on the third day with further progression.The disease progressed with gastrointestinal bleeding and cardiac disorders and ended in death on the ninth day. Conclusion: Fulminant liver damage caused by hepatitis B virus is a severe disease that can be complicated by acute renal failure. The prognosis of the disease is often unfavorable, so optimal treatment requires a liver transplant.

Keywords

• fulminant hepatitis
• hepatitis b virus
• acute renal failure
• lethal outcome