Acute Hepatitis E: A Rare Cause of Acute Liver Failure in a Patient With Acute Myeloid Leukemia

Immunocompromised patients are particularly at risk to develop hepatitis E virus (HEV) infection and its related complications. We present a rare case of HEV infection in a 35-year-old Hispanic female with concomitant acute myeloid leukemia (AML). The patient presented with acute liver failure withi...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2020-09, Vol.12 (9)
Main Authors: Field, Zachary, Russin, Michelle, Murillo Alvarez, Rodrigo M, Madruga, Mario, Carlan, Steve
Format: Article
Language:English
Subjects:
Antibodies
Antigens
Biopsy
Blood
Cancer therapies
Case reports
Chemotherapy
Creatinine
Gallbladder
Gastroenterology
Hematology
Hemoglobin
Hepatitis
Immunoglobulins
Industrialized nations
Infections
Infectious Disease
Internal Medicine
Iron
Laboratories
Leukemia
Liver
Metabolism
Patients
Phosphatase
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Summary:Immunocompromised patients are particularly at risk to develop hepatitis E virus (HEV) infection and its related complications. We present a rare case of HEV infection in a 35-year-old Hispanic female with concomitant acute myeloid leukemia (AML). The patient presented with acute liver failure within a few weeks after receiving a blood transfusion.Our case likely represented an acute de novo HEV infection after chemotherapy in a patient with concurrent AML, evidenced by the presence of anti-HEV IgM antibodies as well as histological findings, and with a previous history of recent transfusions being one of the strongest risk factors for transmission. Liver failure from an acute de novo hepatitis E infection with concurrent AML can be catastrophic in the immunosuppressed patient. Our case is particularly unique due to the uncommon presentation of acute hepatitis E in a non-pregnant reproductive aged Hispanic female with recently diagnosed AML. Clinicians should maintain a low threshold to test serum HEV-RNA if a patient presents with signs and symptoms suggestive of acute hepatitis.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.10628