Fulminant Hepatic Failure in Glucose-6-Phosphate Dehydrogenase (G6PD) Deficient Patients Caused by Hepatitis E Infection: A Single Disease With Different Spectrums

Kamani, Lubna; Shaikh, Hafeezullah; Khemchandani, Ajit Kumar

doi:10.7759/cureus.12276

Cited by 5 publications

(4 citation statements)

References 15 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HMGCR was shown to be significantly involved in cholesterol metabolism in liver and affect bile acid transformation and output (Loh et al, 2018;Chen et al, 2021). G6PD, which induces cancer and promotes cancer progression, was found to be activated by long-term exposure to bile acids (Munemoto et al, 2019), and its absence was shown to induce acute viral hepatitis and lead to liver failure in severe cases (Kamani et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Metabolomics- and systems toxicology-based hepatotoxicity mechanism of Sophorae Tonkinensis Radix et Rhizoma in rats

Shao

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

Drug-induced liver injury (DILI) is a major challenge to the development and clinical application of drugs, especially limits the global application of Chinese herbal medicines, because the material basis and mechanisms of some Chinese herbal medicines are not well clear. In this study, a comprehensive method integrating metabolomics and systems toxicology (SysT) was used to investigate how the main substances in Sophorae TonkinensisRadix et Rhizoma (STRER) influence the metabolic pathways and molecular mechanisms of hepatotoxicity. Through a 28-day continuous oral administration toxicity study combined with serum metabolomics analyses, the aqueous, ethanol-precipitation and dichloromethane extracts of STRER exhibited significant hepatotoxic effects. In addition, 19 differential metabolites with a time-dose-effect relationship were identified in rats. The primary bile acid biosynthesis pathway was significantly altered, which was consistent with the findings of the SysT analysis. Furthermore, through the quantification of bile acids in serum, 16 differential bile acids were identified as being significantly changed; moreover, 21 relevant targets which intersected with the hepatotoxic targets of STRER were identified. Molecular docking was used to confirm the validation of bindings between targets and corresponding compounds, and finally, six important compounds and 14 potential targets were identified to be involved in STRER-induced liver injury in relation to bile acid metabolism.

show abstract

Section: Discussionmentioning

confidence: 99%

Metabolomics- and systems toxicology-based hepatotoxicity mechanism of Sophorae Tonkinensis Radix et Rhizoma in rats

Shao

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

show abstract

“…On review of literature, there are 80 cases related to viral hepatitis, and G6PD deficiency causing severe hemolysis has been reported (Table 1) [2][3][4][5][6][7][8][9][23][24][25][26][27][28][29][30][31][32][33][34][35]. e patient's median age was 19.5 years (IQR: 14.25-35).…”

Section: Discussionmentioning

confidence: 99%

Acute Hepatitis A Causing Severe Hemolysis and Renal Failure in Undiagnosed Glucose-6-Phosphate Dehydrogenase Deficient Patient: A Case Report and Review of the Literature

Abutineh

Kreitman

Kothadia

et al. 2021

Case Reports in Hepatology

View full text Add to dashboard Cite

Infection with hepatitis A virus is usually a self-limited illness that rarely results in fulminant liver failure. Severe hemolysis is an uncommon complication but has been reported in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Here, we report a case with undiagnosed G6PD deficiency who presented with hyperbilirubinemia, severe hemolysis, and acute renal failure precipitated by acute hepatitis A infection.

show abstract

“…Similarly, Mu et al (12) found HEV infection leads to a decrease in platelets and can serve as a short-term prognostic marker for patients with acute HE liver failure. HE infection in patients with G-6-PD de ciency can lead to the development of hemolytic anemia (13). However, most of the previous studies on the extrahepatic manifestations of HE infection were limited to case report, and there was a lack of research on the clinical features and related complications of a large number of HE patients.…”

Section: Introductionmentioning

confidence: 99%

Hematologic system damage is common and related to severity in patients with acute hepatitis E

Cao,

Chen,

Liu

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Extrahepatic manifestations of hepatitis E have been extensively reported, yet there is a lack of comprehensive systematic studies on this aspect. This article is to report hematologic systemdamage caused by hepatitis E. Methods: A retrospective study enrolled 170 patients with acute hepatitis E. The study analyzed the proportion of patients with decreased white blood cell, hemoglobin, and platelet levels in their blood routine, along with their potential clinical significance. 49 patients with HA were also included as controls to compare and analyze the differences in biochemical indicators and hematologic damage. Results: Among the 170 patients with hepatitis E, 47 cases (27.64%) presented with leukopenia, 94 cases (55.29%) exhibited anemia, and 33 cases (19.41%) experienced thrombocytopenia. The findings indicated that hemoglobin and platelets are lower in patients with hepatitis E than in patients with hepatitis A, and anemia is more common in patients with hepatitis E. The anemia group had significantly lower levels of albumin, alanine aminotransferase, and cholinesterase compared to the normal group (p<0.001, p=0.005, p<0.001). Additionally, total bilirubin and alkaline phosphatase were significantly higher in the anemia group than in the normal group (p=0.031, p=0.003). Moreover, the anemia group showed a higher likelihood of experiencing spontaneous bacterial peritonitis (p=0.025). In comparison to the normal platelet group, the thrombocytopenia group exhibited significantly lower levels of albumin, cholinesterase, and prothrombin activity (p=0.036, p=0.015, p<0.001). Patients with decreased platelet have the higher incidence of death, spontaneous bacterial peritonitis, upper gastrointestinal bleeding and hepatorenal syndrome (p<0.001, p<0.001, p=0.027, p=0.014). Conclusion: Hepatitis E patients with hematologic system damage are common. Patients with hepatitis Ehave lower levels of hemoglobin and platelets compared to patients with hepatitis A. The presence of anemia and low platelets in patients with hepatitis Eindicates a more severe condition.

show abstract

Fulminant Hepatic Failure in Glucose-6-Phosphate Dehydrogenase (G6PD) Deficient Patients Caused by Hepatitis E Infection: A Single Disease With Different Spectrums

Cited by 5 publications

References 15 publications

Metabolomics- and systems toxicology-based hepatotoxicity mechanism of Sophorae Tonkinensis Radix et Rhizoma in rats

Metabolomics- and systems toxicology-based hepatotoxicity mechanism of Sophorae Tonkinensis Radix et Rhizoma in rats

Acute Hepatitis A Causing Severe Hemolysis and Renal Failure in Undiagnosed Glucose-6-Phosphate Dehydrogenase Deficient Patient: A Case Report and Review of the Literature

Hematologic system damage is common and related to severity in patients with acute hepatitis E

Contact Info

Product

Resources

About