Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Fatal Acute Hepatitis B Virus Infection while Receiving Immunosuppressants after Renal Transplantation
Takaomi HAMADARyukichi KUMASHIROYuriko KOGATeruko HINOShigeki FURUDERAShotaro SAKISAKAMichio SATAKyuichi TANIKAWAJun TAGUCHIMasayoshi KAGE
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1993 Volume 32 Issue 7 Pages 547-551

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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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