Pancreatic Involvement in Non Fulminant Acute Viral Hepatitis

BACKGROUND: Biliary pathology and alcoholism are responsible for 70 to 80% cases of acute pancreatitis. Viral etiology is not uncommon. OBJECTIVE: To study association of nonfulmimant acute hepatitis with acute pancreatitis. METHODS: We undertook a prospective study over 3 years from Jan 2009 to Dec 2011, during which 950 patients got admitted as acute pancreatitis. RESULTS: Four patients (4.2%) were diagnosed with acute pancreatitis which developed after acute hepatitis. All patients were young (15-36 years); three males and one female. Two patients had pancreatitis in first week and two in third week, after onset of jaundice. Three patients had mild pancreatitis and one had sever pancreatitis. The etiology of pancreatitis was hepatitis A in two, and hepatitis E and hepatitis B in one each. All patients were managed conservatively and recovered completely. CONCLUSIONS: Association between acute pancreatitis and acute viral hepatitis is now more frequently recognized; more commonly in young males, between 1st and third week of hepatitis illness. JMS 2012;15(1):44-46.

Download Full-text

Acute Pancreatitis Complicating Acute Hepatitis E Virus Infection: A Case Report and Review

Case Reports in Hepatology ◽

10.1155/2013/531235 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 9

Author(s):

Hemanta Kumar Nayak ◽

Nitish L. Kamble ◽

Nishant Raizada ◽

Sandeep Garg ◽

Mradul Kumar Daga

Keyword(s):

Acute Pancreatitis ◽

Virus Infection ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Hepatitis E Virus ◽

Acute Viral Hepatitis ◽

Young Male ◽

Hepatitis E ◽

Unusual Complication ◽

Acute Hepatitis E

Acute pancreatitis complicating fulminant viral hepatitis has been well recognized; however, acute pancreatitis occurring in nonfulminant hepatitis is very rare. The case presented describes moderate pancreatitis in a young male, manifesting during the course of nonfulminant acute hepatitis E infection. The diagnosis of acute viral hepatitis E was confirmed by serology and reverse transcriptase polymerase chain reaction (RT-PCR) to demonstrate Hepatitis E virus (HEV) RNA in both stool and serum. Patients with acute viral hepatitis presenting with severe abdominal pain should have a diagnosis of acute pancreatitis suspected and appropriate investigations including serum amylase, lipase, biliary ultrasonography and/or contrast-enhanced computed tomography of the abdomen should be undertaken. The identification of this unusual complication of Hepatitis E is important; however, the prognosis for patients with Acute Pancreatitis Complicating Acute Hepatitis E Virus Infection is good, and uncomplicated recovery with conservative treatment is expected.

Download Full-text

Acute Pancreatitis in acute viral hepatitis

Journal of Nepal Medical Association ◽

10.31729/jnma.20 ◽

2011 ◽

Vol 51 (181) ◽

Author(s):

S K.C. ◽

S Khadka ◽

D Sharma ◽

SP Chataut

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Viral Hepatitis ◽

Hepatitis A ◽

Acute Viral Hepatitis ◽

Ultrasound Examination ◽

Hepatitis E ◽

Severe Abdominal Pain ◽

Gastric Ulcers ◽

Pancreatic Involvement

Introduction: The association of acute viral hepatitis and acute pancreatitis is well described. This study was conducted to find out the frequency of pancreatic involvement in acute viral hepatitis in the Nepalese population. Methods: Consecutive patients of acute viral hepatitis presenting with severe abdominal pain between January 2005 and April 2010 were studied. Patients with history of significant alcohol consumption and gall stones were excluded. Acute viral hepatitis was diagnosed by clinical examination, liver function test, ultrasound examination and confirmed by viral serology. Pancreatitis was diagnosed by clinical presentation, biochemistry, ultrasound examination and CT scan. Results: Severe abdominal pain was present in 38 of 382 serologically-confirmed acute viral hepatitis patients. Twenty five patients were diagnosed to have acute pancreatitis. The pancreatitis was mild in 14 and severe in 11 patients. The etiology of pancreatitis was hepatitis E virus in 18 and hepatitis A virus in 7 patients. Two patients died of complications secondary to shock. The remaining patients recovered from both pancreatitis and hepatitis on conservative treatment. Conclusions: Acute pancreatitis occurred in 6.5 % of patients with acute viral hepatitis. Cholelithiasis and gastric ulcers are the other causes of severe abdominal pain. The majority of the patients recover with conservative management. Keywords: acute viral hepatitis, acute pancreatitis, pain abdomen, hepatitis E, hepatitis A, endemic zone

Download Full-text

A Case of Acute Hepatitis E Complicated by Acute Pancreatitis in Eastern India

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v12i2.513 ◽

2020 ◽

Vol 12 (2) ◽

Author(s):

Rudrajit P ◽

Shubhabrata D ◽

Sourav P ◽

Partha SC ◽

Jayati M ◽

...

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Hepatitis A ◽

Young Male ◽

Hepatitis E ◽

Uneventful Recovery ◽

Eastern India ◽

Acute Hepatitis E

Viral hepatitis may be occasionally associated with acute pancreatitis. Usually the patient presents with abdominal pain in the second or third week of illness. Hepatitis A or E viruses are mostly implicated. HEV related acute pancreatitis was first reported only 12 years ago. We report a case of a young male presenting with acute Hepatitis E infection complicated by pancreatitis. He had an uneventful recovery. This is probably the first report of this association from Eastern India.

Download Full-text

P0627 : Monoclonal gammopathy in patients with acute hepatitis E and other causes of acute viral hepatitis

Journal of Hepatology ◽

10.1016/s0168-8278(15)30832-1 ◽

2015 ◽

Vol 62 ◽

pp. S553-S554

Author(s):

K.L. Woolson ◽

A. Forbes ◽

R.G. Madden ◽

P. Oppong ◽

J.G. Hunter ◽

...

Keyword(s):

Acute Hepatitis ◽

Viral Hepatitis ◽

Monoclonal Gammopathy ◽

Acute Viral Hepatitis ◽

Hepatitis E ◽

Acute Hepatitis E

Download Full-text

Acute viral Hepatitis E in antenatal women: a multicenter prospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182484 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2655

Author(s):

Kaveri Shaw Patel ◽

Manish Tiwari ◽

Sudha Choubey ◽

Anivesh Jain ◽

Lovely Jain ◽

...

Keyword(s):

Prospective Study ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Gestational Age ◽

Acute Viral Hepatitis ◽

Descriptive Analysis ◽

Hepatitis E ◽

High Grade ◽

Total Study Population

Background: Hepatitis E has poor prognosis in pregnancy and leads to 20-30% mortality in term cases. The Aim of the study was to observe the trend of maternal and perinatal outcome in acute viral hepatitis E.Methods: A prospective study conducted in two high risk obstetric center of Jabalpur district in January 2015 to December 2017. The inclusion criteria were all antenatal women diagnosed with acute viral Hepatitis E entering to the Intensive care unit of any gestational age who later delivered in the same center. Other than acute hepatitis E all acute hepatitis cases and women missed in follow up in delivery were excluded from the study. The data collected on demographic, clinical and biochemical variables in excel sheet and descriptive analysis done by SPSS system.Results: There were 72 antenatal women enrolled with mentioned criteria in study duration. Out of these only 67 were in follow up and alive till their delivery in the same set ups. Out of these 70.14% were Primigravida of median age 27 year. The mean gestational age at detection of hepatitis E was 30.3week. The maternal mortality observed was 17.9% (12/67) in the total study population. The high grade of mortality was significantly associated with high grade of disease. There were 19.4% (13/67) perinatal (mortality seen which included intrauterine (14.9%) and neonatal (4.4%).Conclusions: The severity of Hepatitis and high grade of hepatic encephalopathy following poor primary care in the beginning of disease results in poor perinatal and maternal outcome.

Download Full-text

Acute pancreatitis associated with acute viral hepatitis: case report and review of literature

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652009000600008 ◽

2009 ◽

Vol 51 (6) ◽

pp. 349-351 ◽

Cited By ~ 5

Author(s):

Danilo Bora Moleta ◽

Fábio Toshio Kakitani ◽

Adma Silva de Lima ◽

João César Beenke França ◽

Sonia Mara Raboni

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Case Report ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Acute Viral Hepatitis ◽

Hepatitis Virus ◽

Common Disease ◽

Review Of Literature ◽

Hepatitis Case

This case report, along with the review presented, describes a patient diagnosed with acute viral hepatitis, who developed a framework of intense abdominal pain and laboratorial alterations compatible with acute pancreatitis. The association of acute pancreatitis complicating fulminant and non-fulminant acute hepatitis virus (AHV) has been reported and several mechanisms have been proposed for this complication, but so far none is clearly involved. As acute hepatitis is a common disease, it is important to stimulate the development of other studies in order to determine local incidence and profile of patients presenting this association in our environment.

Download Full-text

Seroprevalence of Enterically Transmitted Hepatitis Viruses in Patients Attending a Tertiary Care Hospital in Maharashtra, India

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/472 ◽

2021 ◽

Vol 10 (30) ◽

pp. 2310-2313

Author(s):

Suvarna Vaibhav Sande

Keyword(s):

Acute Hepatitis ◽

Viral Hepatitis ◽

Predictive Value ◽

Hepatitis A ◽

Acute Viral Hepatitis ◽

Tertiary Care ◽

Hepatitis E ◽

Care Hospital ◽

Serum Samples ◽

Hepatitis Viruses

BACKGROUND Hepatitis A & E viruses are enterically transmitted viruses responsible for acute viral hepatitis in developing countries. Hepatitis A virus (HAV) has worldwide distribution while hepatitis E virus (HEV) is restricted to tropical countries. HAV affects infants and young children while HEV affects older children and young adults. This study was conducted to determine the seroprevalence of HAV and HEV and their co-infection in patients presenting with acute viral hepatitis (AVH). METHODS 200 sera of patients suffering from suspected acute viral hepatitis (AVH) attending tertiary care rural hospital JNMC Sawangi, Wardha were included in the study. Serum samples were tested for IgM anti HAV and IgM anti - HEV for the detection of acute hepatitis A and acute hepatitis E using commercially available ELISA kit & Immunochromatography test (ICT) for comparison of ELISA and ICT. RESULTS The overall seroprevalence of HAV and HEV infection was found to be 19 %. The seroprevalence of HAV infection was found to be 13 %, HEV infection 5 % and HAV - HEV co - infection 1 %. HAV infection in males and females was found to be 16.07 % and 9.09 % respectively & HEV infection was found to be 5.35 % and 4.54 % respectively. In case of detection of HAV IgM, two serum samples were negative by ICT but positive by ELISA & for HEV IgM, one serum sample was negative by ICT but positive by ELISA. The sensitivity, specificity, positive predictive value and negative predictive value of HAV IgM was found to be 96 %, 98.8 %, 92.30 % & 99.43 % and for HEV IgM was found to be 90 %, 99.47 %, 90 % & 99.47 % respectively. CONCLUSIONS It is evident from this study that infection with enteric hepatitis viruses is not infrequent. Findings from this study emphasize the need to establish regular seroepidemiological surveys to keep track of epidemiology of these viruses. Results from rapid tests are comparable to ELISA with additional advantage of ease of interpretation and neither time consuming nor requiring special instruments. KEY WORDS Hepatitis A, Hepatitis E, Seroprevalence

Download Full-text

Acute viral hepatitis E complicated with acute pancreatitis in an immunocompetent adult

BMJ Case Reports ◽

10.1136/bcr-2020-239684 ◽

2021 ◽

Vol 14 (2) ◽

pp. e239684

Author(s):

Partha Debnath ◽

Amlan Kusum Datta ◽

Uddalak Chakraborty ◽

Atanu Chandra

Keyword(s):

Acute Pancreatitis ◽

Liver Failure ◽

Viral Hepatitis ◽

Acute Viral Hepatitis ◽

Hepatitis E ◽

Ampulla Of Vater ◽

Pancreatic Acinar Cells ◽

Immunocompetent Adult ◽

Immunocompetent Individual ◽

Immune Mediated

Acute viral hepatitis has been associated with several extrahepatic complications. Fulminant liver failure secondary to acute viral hepatitis may be complicated by acute pancreatitis. However, in the setting of benign viral hepatitis, in the absence of liver failure, association of pancreatitis is uncommon, that too in an otherwise immunocompetent individual. The exact mechanism of hepatitis-related pancreatitis remains elusive. Proposed mechanisms include immune-mediated injury against infected pancreatic acinar cells, oedema of the ampulla of Vater and release of lysosomal enzymes from the liver. A high index of clinical suspicion is needed in any case of viral hepatitis with severe abdominal pain to recognise acute pancreatitis as a possible complication, which may increase both morbidity and mortality if unrecognised. Herein, we report a case of a young man presenting with acute viral hepatitis due to hepatitis E infection, complicated by acute pancreatitis.

Download Full-text

Prevalence of hepatitis A virus and hepatitis E virus in the patients presenting with acute viral hepatitis in Rohtak, Haryana, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191678 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1792 ◽

Cited By ~ 1

Author(s):

Sarita Rawat ◽

P. S. Gill ◽

Tanuj Gupta ◽

Praveen Malhotra ◽

Aparna Parmar

Keyword(s):

Acute Hepatitis ◽

Viral Hepatitis ◽

Hepatitis E Virus ◽

Hepatitis A ◽

Acute Viral Hepatitis ◽

Hepatitis A Virus ◽

Hepatitis E ◽

Interquartile Range ◽

Seroprevalence Rate ◽

Age Group

Background: Hepatitis A virus (HAV) and hepatitis E virus (HEV) cause acute hepatitis in humans and are transmitted mainly through the fecal-oral route. They pose major health problems in developing countries. This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients.Methods: The study was conducted in the virology research and diagnostic laboratory, PGIMS Rohtak during the study period of August 2017-December 2018. The study population included sera of individuals from all age group who were suspected of acute viral hepatitis (AVH). All the sera were screened for IgM antibody to HEV and HAV using IgM capture ELISA.Results: HEV IgM ELISA test was performed in 307 patients (mean age 34 years;), with an overall seroprevalence rate of 138(44.9%). HAV antibodies were detected in 109 subjects, with a median age of 9.5 years the seroprevalence of HAV was 34 (31.1%). HEV seropositivity was highest in the age group 20-30 years. Mean age was 34 years whereas the interquartile range was from 14-71 years. HAV infection was positive mainly in the age group <10 years. With interquartile range from 6-16 years. Out of total 34 patients positive for HAV infection males were 20 (58.8%), whereas females were 14(41.1%). HEV IgM was positive in 138 patients, out of which male were 96 (69.56%) and females were 42 (30.43%). HEV IgM was positive in 138 patients, out of which male were 96 (69.56%) and females were 42 (30.43%). HAV and HEV seen to be prevalent all with highest predominance seen towards the end of monsoons (August and September) and beginning of winters.Conclusions: The present study also points toward HEV being the prime etiological agent for outbreaks of acute hepatitis in the studied region of Haryana (Rohtak), India. A comparatively lower HAV prevalence may be the consequence of an overall declining trend due to improved living standards and environmental hygiene.

Download Full-text