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- Title
Fulminant hepatitis due to human adenovirus.
- Authors
Ronan, B.; Agrwal, N.; Carey, E.; Petris, G.; Kusne, S.; Seville, M.; Blair, J.; Vikram, H.
- Abstract
Purpose: To describe the demographics, clinical manifestations, treatment and outcomes of patients with human adenovirus (HAdV) hepatitis. Methods: A case of fulminant HAdV hepatitis in a patient with chronic lymphocytic leukemia receiving rituximab and fludarabine is described. We conducted a comprehensive review of the English-language literature through May, 2012 in search of definite cases of HAdV hepatitis. Results: Eighty-nine cases were reviewed. Forty-three (48 %) were liver transplant recipients, 19 (21 %) were bone marrow transplant recipients, 11 (12 %) had received chemotherapy, five (6 %) had severe combined immunodeficiency, four (4 %) were HIV infected, two had heart transplantation, and two were kidney transplant recipients. Ninety percent (46/51) of patients presented within 6 months following transplantation. Fever was the most common initial symptom. Abdominal CT scan revealed hypodense lesions in eight of nine patients. Diagnosis was made by liver biopsy in 43 (48 %), and on autopsy in 46 (52 %). The HAdV was isolated at other sites in 54 cases. Only 24 of 89 patients (27 %) survived: 16 whose immunosuppression was reduced, six with liver re-transplantation, and two who received cidofovir and intravenous immunoglobulin. Conclusion: HAdV hepatitis can manifest as a fulminant illness in immunocompromised hosts. Definitive diagnosis requires liver biopsy. Early consideration of a viral etiology, reduction in immunosuppression, and liver transplantation can be potentially life-saving.
- Subjects
CHRONIC lymphocytic leukemia; HEPATITIS; IMMUNOHISTOCHEMISTRY; MEDICAL information storage &; retrieval systems; LIVER failure; MEDLINE; ONLINE information services; TOMOGRAPHY; VIRUSES; SYSTEMATIC reviews; ACUTE diseases
- Publication
Infection, 2014, Vol 42, Issue 1, p105
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-013-0527-7