Fatal Acute Hepatitis B Virus Infection while Receiving Immunosuppressants after Renal Transplantation

Takaomi HAMADA; Ryukichi KUMASHIRO; Yuriko KOGA; Teruko HINO; Shigeki FURUDERA; Shotaro SAKISAKA; Michio SATA; Kyuichi TANIKAWA; Jun TAGUCHI; Masayoshi KAGE

doi:10.2169/internalmedicine.32.547

Takaomi HAMADA, Ryukichi KUMASHIRO, Yuriko KOGA, Teruko HINO, Shigeki FURUDERA, Shotaro SAKISAKA, Michio SATA, Kyuichi TANIKAWA, Jun TAGUCHI, Masayoshi KAGE

Author information

Takaomi HAMADA
the Second Department of Internal Medicine, Kurume University of Medicine
Ryukichi KUMASHIRO
the Second Department of Internal Medicine, Kurume University of Medicine
Yuriko KOGA
the Second Department of Internal Medicine, Kurume University of Medicine
Teruko HINO
the Second Department of Internal Medicine, Kurume University of Medicine
Shigeki FURUDERA
the Second Department of Internal Medicine, Kurume University of Medicine
Shotaro SAKISAKA
the Second Department of Internal Medicine, Kurume University of Medicine
Michio SATA
the Second Department of Internal Medicine, Kurume University of Medicine
Kyuichi TANIKAWA
the Second Department of Internal Medicine, Kurume University of Medicine
Jun TAGUCHI
the First Department of Pathology, Kurume University of Medicine
Masayoshi KAGE
the First Department of Pathology, Kurume University of Medicine

Keywords: liver failure, fibrosis, HBc antigen, HBV core particle, regeneration

JOURNAL FREE ACCESS

1993 Volume 32 Issue 7 Pages 547-551

DOI https://doi.org/10.2169/internalmedicine.32.547

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Abstract

A 47-year-old man with acute hepatitis B virus (HBV) infection who had been receiving immunosuppressants after renal transplantation developed progressive liver failure. During the clinical course (approximately 7 months), anti-HBc IgM antibody and HBV-DNA polymerase levels remained high, but the serum alanine aminotransferase (ALT) level was consistently less than 150 K.U. Histopathologic examination of the liver showed submassive hepatic necrosis without significant inflammation accompanied by marked fibrosis. Most hepatocytes showed strong nuclear expression of HBc antigen by immunohistochemical staining and electron microscopy revealed numerous intranuclear core-like particles. Hepatitis B virus infection in immunosuppressed individuals occasionally insidiously progresses, resulting in liver failure. The clinical course of such patients thus merits close scrutiny.
(Internal Medicine 32: 547-551, 1993)

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