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Hepatic Failure Due to Hepatitis E Virus Infection in a Patient with Necrotic Hepatocellular Carcinoma

대한간암학회지 2019년 19권 1호 p.55 ~ 58
김지혜, 도영석, 장지웅, 강민석, 김낙민, 김새희, 백일현, 정성희,
소속 상세정보
김지혜 ( Kim Ji-Hye ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
도영석 ( Doh Young-Seok ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
장지웅 ( Jang Ji-Woong ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
강민석 ( Kang Min-Seok ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
김낙민 ( Kim Nak-Min ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
김새희 ( Kim Sae-Hee ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
백일현 ( Baek Il-Hyun ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine
정성희 ( Jung Sung-Hee ) - Eulji University College of Medicine Eulji University Hospital Department of Internal Medicine

Abstract


In patients with hepatocellular carcinoma (HCC) or liver cirrhosis (LC) accompanied by hepatitis E virus (HEV) infection, hepatic failure often leads to debility. Here, we report about a 63-year-old man with alcoholic LC who was referred to our hospital with jaundice and abdominal distension 10 days earlier. Abdominal computed tomography showed necrotic HCC accompanied by left lobe shrinkage without tumor progression. Laboratory and imaging findings revealed no acute infection focus. The patient reported no herbal medicine or alcohol consumption, and there was no evidence of acute viral hepatitis. One month later, HEV immunoglobulin M positivity was confirmed, and deterioration of liver function due to HEV infection was suspected. The patient often ate raw oysters and sashimi, as well as boar meat, which is a well-known risk food for HEV infection. His umbilical hernia deteriorated due to tense ascites and infection by skin abrasion. The patient progressed to hepatorenal syndrome and eventually died. Liver function preservation is important when treating HCC patients. Therefore, clinicians should pay more attention to the prevention of HEV and others causes of direct liver injury.

키워드

Hepatocellular carcinoma; Regression; Hepatitis E virus; Liver failure

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