Acute pancreatitis following kidney transplantation – role of viral infections

Sinha, Sanjay; Jha, Ratan; Lakhtakia, Sundeep; Narayan, Girish

doi:10.1034/j.1399-0012.2003.02041.x

Cited by 52 publications

(54 citation statements)

References 19 publications

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“…Acute pancreatitis has been associated with HEV1 infection (46)(47)(48)(49). However, no cases of pancreatitis have been reported with any of the other genotypes.…”

Section: Extrahepatic Manifestations Of Hevmentioning

confidence: 99%

Hepatitis E Virus Infection

et al. 2014

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SUMMARY Hepatitis E virus (HEV) infection is a worldwide disease. An improved understanding of the natural history of HEV infection has been achieved within the last decade. Several reservoirs and transmission modes have been identified. Hepatitis E is an underdiagnosed disease, in part due to the use of serological assays with low sensitivity. However, diagnostic tools, including nucleic acid-based tests, have been improved. The epidemiology and clinical features of hepatitis E differ between developing and developed countries. HEV infection is usually an acute self-limiting disease, but in developed countries it causes chronic infection with rapidly progressive cirrhosis in organ transplant recipients, patients with hematological malignancy requiring chemotherapy, and individuals with HIV. HEV also causes extrahepatic manifestations, including a number of neurological syndromes and renal injury. Acute infection usually requires no treatment, but chronic infection should be treated by reducing immunosuppression in transplant patients and/or the use of antiviral therapy. In this comprehensive review, we summarize the current knowledge about the virus itself, as well as the epidemiology, diagnostics, natural history, and management of HEV infection in developing and developed countries.

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“…Acute pancreatitis has been associated with HEV1 infection (46)(47)(48)(49). However, no cases of pancreatitis have been reported with any of the other genotypes.…”

Section: Extrahepatic Manifestations Of Hevmentioning

confidence: 99%

Hepatitis E Virus Infection

et al. 2014

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“…These manifestations have been observed with HEV genotypes 1 and 3. In addition, several cases of pancreatitis have been reported following infection with HEV genotype 1 (Sinha et al 2003;Bhagat et al 2008;Thapa et al 2009;Deniel et al 2011). …”

Section: Hev-induced Extra-hepatic Manifestationsmentioning

confidence: 96%

Hepatitis E: The Commonest Viral Zoonosis Worldwide?

Dalton

Izopet

Banks³

et al. 2014

Zoonoses - Infections Affecting Humans and Animals

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Until recently, HEV was thought not to occur in developed countries. It is now clear that locally acquired HEV is common in many developed countries. HEV infection acquired in these areas differs from that in developing countries in a number of important aspects: it is caused by genotype 3 (and 4 in China and Japan); it mainly affects middle-aged/elderly males; it is zoonotic with a porcine primary host. Pig herds worldwide are infected with HEV genotype 3 and HEV has been found in the human food chain in a number of developed countries. However, the route of transmission is not fully understood, since most cases are not obviously associated with pigs/pig products. HEV can be transmitted by blood transfusion and surprisingly high numbers of asymptomatic blood donors are viraemic at the time of donation.Our understanding of the clinical phenotype of HEV infection in humans has undergone a sea-change in recent years. Previously, HEV was thought to cause only acute self-limiting hepatitis. However, HEV may cause persistent disease in the immunocompromised. Patients with chronic HEV infection have no symptoms, but some develop rapidly progressive liver cirrhosis. The full clinical spectrum of HEV is still emerging. HEV has important extra-hepatic manifestations, which deserve further investigation. For example, HEV can cause a wide range of neurological illness. In particular, very recent data suggests that Guillain-Barré syndrome and neuralgic amyotrophy are associated with locally acquired HEV in approximately 5% and 10% of cases respectively. Overview of Virology of HEVHEV is a small non-enveloped virus with an icosahedral capsid and a size of 27-34 nm. The virus has a positive-sense, single-stranded RNA 7.2-kilobases-long genome which is capped and polyadenylated at the 5' and 3'-termini, respectively (Reyes et al. 1990;Tam et al. 1991). The HEV genome contains three open reading frames (ORF). ORF1 encodes a protein of 1693 amino acids containing functional domains present in the non-structural proteins of other positive-stranded RNA viruses (Koonin et al. 1992). These functional domains include methyltransferase, cysteine protease, RNA helicase and RNA-dependent RNA polymerase. ORF2 encodes the viral capsid protein of 660 amino acids that is responsible for virion assembly (Li et al. 1997), interaction with target cells (He et al. 2008;Kalia et al. 2009), and immunogenicity (Xing et al. 2011). The ORF2 protein consists of three linear domains, the shell domain (S) (amino acids 129-319), the middle domain (M) (amino acids 320-455), and protruding domain (P) (amino acids 456-606) harbouring the neutralizing epitope(s) (Guu et al. 2009;Tang et al. 2011;Xing et al. 2010;Yamashita et al. 2009). ORF3, which overlaps ORF2, encodes a small protein of 113 or 114 amino acids involved in virion morphogenesis and release (Emerson et al. 2010;Yamada et al. 2009). HEV replicates in the cytoplasm, with a subgenomic RNA producing OFR2 and OFR3 proteins and the full genomic RNA encoding non-structural proteins and ser...

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“…102,103 In addition, glomerular lesions, such as membrano-proliferative glomerulonephritis and membranous glomerulonephritis, have been reported in kidney-and liver-transplant patients. 104 Furthermore, cryoglobulinemia has been detected in transplant patients with chronic HEV-3 infection. Further studies are required to confirm these preliminary data.…”

Section: Kidney Manifestationsmentioning

confidence: 99%

“…Only HEV genotype-1-induced acute pancreatitis has been reported [104][105][106][107] : no cases of genotype-3-induced pancreatitis have been reported. In addition, a few cases of severe thrombocytopenia have been observed during the acute phase of HEV infection.…”

Section: Other Hev-related Extra-hepatic Manifestationsmentioning

confidence: 99%