Abstract
Recently we have encountered a case of type B fulminant hepatitis which is thought to have been caused by blood transfusion after gastrectomy for advanced gastric cancer.
The results of examination of the donor blood (samples for cross-matching) showed that all of the 9 bottles of preserved blood were HBs antigen negative (R-PHA and RIA), but one of them had an anti-HBc level of 1:1024 (IAHA), and this was considered to have caused type B post-transfusion hepatitis.
The patient was a 47-year-old man. 1800 ml of preserved blood was transfused befbre and during the operation for gastric cancer. Three months after the operation, jaundice appeared, accompanied by a temparature up to 38.5 C. Also, slight psychoneurological abnormalities were present, and those continued for about 10 days. But only jaundice gradually disappeared. Although both the HBs antigen and the HBs antibody were negative before blood transfusion, when the hepatitis occurred the presence of HBs antigen and HBs antibody in the serum, a temporary disappearance of HBs antigen, and a overproduction of HBs antibody prior to the increase of anti-HBc were observed.
The histological findings of the liver biopsy performed 9 weeks after the onset of the fulminant hepatitis indicate the convalescent stage of acute viral hepatitis with confluent necrosis without orcein positive hepatocytes.
