Co-existence of hepatitis A and adult Reye's syndrome
Co-existence of hepatitis A and adult Reye's syndrome
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DOI：
10.1136/gut.41.1.121
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发表时间：
1997-07-01
期刊：
影响因子：
24.5
通讯作者：
Bain, VG
中科院分区：
文献类型：
--
作者：
Duerksen, DR;Jewell, LD;Bain, VG
雷氏综合征最常见于儿童，但也见于成人。这种综合征通常与摄入5-氨基水杨酸酯（ASA）或感染甲型流感、乙型流感或水痘病毒有关。一例雷氏综合征在一个47岁，以前健康的妇女沉淀摄入ASA和急性甲型肝炎病毒感染被描述。根据她的临床过程，肝微泡性脂肪变性和肝细胞线粒体的特征性电镜改变，诊断为Reye综合征。A型肝炎的诊断是基于高于雷氏综合征的转氨酶值，病毒血清学包括A型肝炎IgM的存在，以及原位杂交肝活检显示的A型肝炎病毒RNA。线粒体损伤已在急性甲型肝炎中得到证实，除ASA外，该患者还可能发生雷氏综合征。甲型肝炎和雷氏综合征之间的关系以前没有报道过。由于在雷氏综合征患者中没有常规寻找甲型肝炎病毒感染，因此这种关联的频率尚不清楚。
Reye's syndrome is most frequently seen in children but has also been described in adults. This syndrome is usually associated with ingestion of 5-aminosalicylates (ASA) or infection with influenza A, influenza B, or varicella virus. A case of Reye's syndrome in a 47 year old, previously healthy woman precipitated by ingestion of ASA and acute hepatitis A virus infection is described. Reye's syndrome was diagnosed on the basis of her clinical course, and the presence of hepatic microvesicular steatosis and characteristic electron microscopic changes in the hepatocyte mitochondria. The diagnosis of hepatitis A was based on higher aminotransferase values than would be expected in Reye's syndrome alone, viral serology including the presence of hepatitis A IgM and the demonstration of hepatitis A virus RNA on liver biopsy by in situ hybridisation. Mitochondrial injury has been demonstrated in acute hepatitis A which, in addition to ASA, may have precipitated Reye's syndrome in this patient. The association between hepatitis A and Reye's syndrome has not been reported before. As hepatitis A virus infection is not sought routinely in patients with Reye's syndrome, the frequency of this association is unknown.