• Internal medicine · Jun 2021

    Case Reports

    An Autopsy Case of Primary Biliary Cholangitis with Histological Submassive Hepatic Necrosis Caused by Acute Hepatitis E Virus Infection.

    • Mizuki Koyama, Tomoo Yamazaki, Satoru Joshita, Akihiro Ito, Kazuyuki Ono, Takayuki Watanabe, Yuki Yamashita, Ayumi Sugiura, Mikiko Kobayashi, Yoshinori Sato, Masaharu Takahashi, Hiroaki Okamoto, and Takeji Umemura.
    • Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Japan.
    • Intern. Med. 2021 Jun 15; 60 (12): 1863-1870.

    AbstractA 59-year-old woman who had been diagnosed with cirrhotic primary biliary cholangitis (PBC) 5 years earlier was admitted for severe jaundice (total bilirubin: 30.1 mg/dL). We suspected that her cirrhotic PBC had deteriorated acutely for some reason. Her general condition deteriorated quickly, and she passed away on day 18 of admission. Hepatitis E virus (HEV)-IgA antibodies were positive, and Genotype 3b HEV involvement was confirmed from a blood sample taken on admission. Histopathological findings revealed cirrhosis and submassive loss and necrosis of hepatocytes. Clinicians should consider the possibility of acute HEV infection as a trigger for acute PBC exacerbation.

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