Hepatic Artery Emboli Causing Fulminant Hepatitis

Béland, Mathieu; Despatis, Marc-Antoine; Gahide, G.

doi:10.1016/j.jvir.2018.11.020

Cited by 1 publication

(4 citation statements)

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“…On the other hand, the peak AST and ALT values were only 3,157 and 2,945 IU/l in the present case, respectively. The difference in hepatitis severity between the present case and that of Béland et al (6) may be due to the difference in the cause of arterial occlusion (embolization derived from destruction of vegetation and thrombosis). Furthermore, the diffusion-weighted imaging of hepatic MRI showed a low-intensity area in part of the liver in the present case.…”

Section: Sle Causes Chronic Inflammation In Multiple Organs (8)contrasting

confidence: 63%

“…In the present case, the patient also had severe hepatic dysfunction with PT <40%, but fulminant hepatitis did not develop. The case of Béland et al ( 6 ) showed severe hepatic enzyme elevations due to hepatic artery occlusion, with AST >15,000 IU/l and ALT >6,000 IU/l. On the other hand, the peak AST and ALT values were only 3,157 and 2,945 IU/l in the present case, respectively.…”

Section: Discussionmentioning

confidence: 98%

“…Ischemic hepatitis is an hepatic tissue injury that manifests as a result of hypoxia caused by hepatic hypoperfusion. Hepatic hypoperfusion is most commonly caused by acute cardiac failure, toxic shock states and respiratory failure ( 5 ), but hepatic artery occlusion is a rare cause of significant hepatic ischemia ( 6 ). Hepatic artery thrombosis, which can induce hepatic artery occlusion and/or a hepatic artery blood inflow disturbance, is the most common complication following liver transplantation or other surgical procedures ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

“…An isolated hepatic artery occlusion is usually considered an unlikely cause of significant hepatic ischemia in non-transplant patients and is considered an unlikely cause of significant hepatic ischemia, as there is a dual blood supply to the liver that comes from the portal vein and hepatic artery ( 7 ). However, Béland et al ( 6 ) reported a case of fulminant hepatitis caused by common hepatic artery occlusion in a patient with a history of atrial fibrillation ( 6 ). As the values of FDP and D-dimer decreased after starting treatment, thrombosis was unlikely to have caused ischemic hepatitis in the present case.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Ischemic hepatitis with infectious endocarditis: A case report

Okano¹,

Okado²,

Ito

et al. 2021

Biomed Rep

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A 58-year-old woman was admitted to Suzuka General Hospital with fever. She was diagnosed with infectious endocarditis based on the presence of anterior mitral leaflet vegetation on the echocardiography analysis and isolation of Pseudomonas guariconensis by blood culture. During treatment, the hepatic enzymes levels, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) were increased without any abdominal symptoms. Prolonged prothrombin time (PT) and prothrombin time international normalized ratio were observed, and acute hepatic failure was diagnosed. However, the hepatic injury resolved spontaneously with restoration of the PT value after the hepatic enzymes (AST, ALT, LDH and ALP) peaked. Diffusion-weighted imaging of hepatic magnetic resonance imaging showed diffuse high intensity of the entire liver except for part of the left lobe. The hepatic injury was diagnosed as ischemic hepatitis caused by embolization from the vegetation associated with infectious endocarditis. The recovery from hepatic ischemia was thought to be due to hepatic blood supply from extrahepatic collateral blood. After antibiotic treatment, the patient underwent resection of the vegetation on the anterior mitral valve leaflet. Hepatic artery occlusion is rare, but it may cause severe hepatic complications. During follow-up of infectious endocarditis, clinicians should be aware of the potential for whole organ ischemic damage caused by vessel occlusion, as well as hepatic ischemic damage.

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Section: Sle Causes Chronic Inflammation In Multiple Organs (8)contrasting

confidence: 63%

Section: Discussionmentioning

confidence: 98%