Successful treatment of fulminant hepatitis A with acute renal failure by plasma exchange

Abstract

A 48-year-old male was admitted to wakayama Medical School due to severe liver disorder (GOT 31, 560U/l, GPT 9, 330U/l) and renal failure (BUN 70mg/dl, Cr 6.0mg/dl). On laboratory examination, PT was as low as 11% and a virus marker showed acute hepatitis A. These findings indicated fulminant hepatitis A. Plasma exchange (PE) was performed 3 times, hemodialysis (HD) and hemodiafiltration (HDF) were performed for acute renal failure. PT improved by PE and liver and renal functions improved.
The vast majority of cases of hepatitis A require no specific therapy. However, the intensive liver support by PE must be performed when hepatitis A develops into fulminant hepatitis.