Hepatitis viruses causing pancreatitis and hepatitis - A case series and review of literature
Hepatitis viruses causing pancreatitis and hepatitis - A case series and review of literature
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DOI：
10.1097/mpa.0b013e31815d9d53
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发表时间：
2008-05-01
期刊：
影响因子：
2.9
通讯作者：
Arora, Anil
中科院分区：
文献类型：
--
作者：
Bhagat, Sandeep;Wadhawan, Manav;Arora, Anil
目的：急性胰腺炎与急性病毒性肝炎（AVH）之间的关联比以往认为的更为常见。大多数病例与甲型或乙型肝炎病毒有关。到目前为止，仅有6例急性胰腺炎合并急性戊型肝炎病毒（HEV）相关肝炎的病例被报道。
方法：我们分析了2004年12月至2006年3月期间收治的334例急性胰腺炎患者的住院病历。其中7例患者伴有相关的急性病毒性肝炎。
结果：在这些患者中，4例为戊型肝炎病毒相关的急性病毒性肝炎，3例为甲型肝炎病毒相关的急性病毒性肝炎。除1例外，其余均为年轻男性，在肝炎发病的第2至第3周出现腹痛。无胆绞痛、酗酒、腹部外伤史，无服用可导致胰腺炎的药物史，也无胰腺炎家族史。平均胆红素为10.74 mg/dL；丙氨酸氨基转移酶水平为482.85 IU/L；血清淀粉酶为1263.57 IU/L。所有患者都有胰腺炎的影像学证据。2例戊型肝炎病毒相关疾病患者患有D - E级胰腺炎。所有患者均接受保守治疗并完全康复。
结论：急性胰腺炎与非暴发性病毒性肝炎之间的关联现在更常被认识到。戊型肝炎病毒在肝炎发病的第2和第3周在年轻男性中更为常见，可能与重症胰腺炎有关。
Objectives: Association between acute pancreatitis and acute viral hepatitis (AVH) is more frequent than previously thought. Most cases are hepatitis A or B virus related. Only 6 cases of acute pancreatitis with acute hepatitis E virus (HEV)-related hepatitis has been reported so far.Methods: We analyzed the hospital records of 334 patients of acute pancreatitis admitted from December 2004 to March 2006. Seven patients had an associated AVH.Results: Of these, 4 had HEV-related and 3 had hepatitis A virus-related AVH. All but one were young males who presented with abdominal pain during the second to third week of hepatitis illness. None had a history of biliary colic, alcoholism, abdominal trauma, or intake of drugs causing pancreatitis or a family history of pancreatitis. Mean bilirubin was 10.74 mg/dL; alanine aminotransferase levels, 482.85 IU/L; and serum amylase, 1263.57 IU/L. All patients had an imaging evidence of pancreatitis. Two patients with HEV-related disease had grades D to E pancreatitis. All were managed conservatively and recovered completely.Conclusions: Association between acute pancreatitis and nonfulminant viral hepatitis is now more frequently recognized. Seen more commonly in young males during the second and third week of hepatitis illness, HEV might be associated with severe pancreatitis.