International Medical Case Reports Journal (Oct 2022)

A Case of Hepatitis E Virus Infection: One of Differential Diagnosis of Liver Injury in Patients Undergoing Peritoneal Dialysis

  • Yan T,
  • Sakai Y,
  • Terada K,
  • Okano S,
  • Kawasaki S,
  • Kashiwagi T,
  • Iwabu M

Journal volume & issue
Vol. Volume 15
pp. 557 – 561

Abstract

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Tomohiro Yan, Yukinao Sakai, Kohsuke Terada, Sho Okano, Sayuri Kawasaki, Tetsuya Kashiwagi, Masato Iwabu Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, JapanCorrespondence: Yukinao Sakai, Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan, Tel +81-03-3822-2131, Fax +81-3-3822-4865, Email [email protected]: There are numerous causes of liver function disorder in patients undergoing peritoneal dialysis (PD). Infection with the Hepatitis E virus (HEV) is a rare cause of liver injury, and the behavior of HEV in patients with PD is unclear. Since patients undergoing dialysis are frequently polypharmatic, liver injury caused by HEV infection may be misdiagnosed as drug-induced liver injury.Case Presentation: A 61-year-old woman with PD developed abrupt elevation of blood transaminase levels on a routine outpatient session. Since the patient has been receiving tolvaptan as the only new medication, we suspected tolvaptan induced liver injury. In further investigating the cause of liver injury, the blood screening test was found to be positive for HEV-IgA. The patient was diagnosed with HEV infection, and had a self-limited course.Conclusion: When encountered with patients developing liver injury during PD, HEV infection should be included in the differential diagnosis.Keywords: peritoneal dialysis, hepatitis E virus, HEV infection, liver injury

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