Interstitial nephritis, acute renal failure in a patient with non-fulminant hepatitis A infection

Al, Vaboe; Leh, Sabine; Forslund, Terje

doi:10.5414/cnp57149

Cited by 22 publications

(16 citation statements)

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“…[8][9][10][11][12][13][14][15][16][17][18] However, recent studies in Korea have suggested that AKI is not a rare complication having incidence rate from 3% up to 7.2%. [2][3][4][5] In this study, the rates of AKI were 7.6% in whole hepatitis A cases, and 5.8% in nonfulminant cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of acute kidney injury among patients with acute hepatitis A

Choi

Song

Han

et al. 2011

Journal of Clinical Virology

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Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of acute kidney injury among patients with acute hepatitis A

Choi

Song

Han

et al. 2011

Journal of Clinical Virology

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“…Causes of acute kidney injury in hepatitis A infection include myoglobinuria secondary to polymyositis from infiltration by inflammatory cells and acute necrosis of the muscle fibers; circulating immune-complex mediated nephritis; and cryoglobulinemia or by direct viral invasion [9–13]. Kidney biopsies in cases of renal failure in patients with hepatitis A have shown interstitial nephritis, acute tubular necrosis, and some with no renal pathology.…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Hepatitis A Infection with Extrahepatic Manifestations

Bhatt

Sandhu

Mitchell

2014

Case Reports in Gastrointestinal Medicine

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Hepatitis A has a variety of associated extrahepatic manifestations that clinicians should be aware of for early diagnosis and treatment. We report a unique case of hepatitis A presenting with multiple extrahepatic manifestations not previously described in a single patient. A 34-year-old male presented with sudden onset of left sided facial pain, swelling, and skin rash, with diffuse body pains and muscle weakness, and was found to be positive for hepatitis A immunoglobulin M (IgM). He was initially started on antibiotics for concerns of bacterial parotitis but did not show any improvement. A punch biopsy of his mandibular rash and swelling was done which showed lymphohistiocytic infiltration with a few eosinophils. A trial of prednisone resulted in improvement of his symptoms. Clinicians should be aware to look for hepatitis A infection in a patient with atypical clinical picture causing a widespread systemic inflammatory response. Treatment with prednisone may result in resolution.

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“…The prognosis of renal failure as a result of HAV infection is generally benign, although the recovery can be substantially delayed [20]. The patients with AHA associated ARF in this study had a benign clinical course except in the case that developed fulminant hepatic failure.…”

Section: Discussionmentioning

confidence: 91%

“…In the present study, all patients with AHA‐associated ARF had haematuria and proteinuria suggestive of glomerulonephritis. However, in contrast to the findings associated with HBV and HCV infections where glomerular disease is predominantly found, HAV infection was associated with interstitial nephritis and acute tubular necrosis [20]. These differences might be related to the fact that HBV and HCV have a stronger affinity for the kidneys compared to HAV [20].…”

Section: Discussionmentioning

confidence: 95%

Clinical features of acute renal failure associated with hepatitis A virus infection

Jung

Kim

Jeong

et al. 2009

Journal of Viral Hepatitis

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Acute hepatitis A (AHA) is one of the most common infectious diseases; it is usually a self-limiting disease affecting the liver. Although extrahepatic manifestations are not common, some cases have been reported associated with acute renal failure. We reviewed the clinical features of patients with AHA complicated by acute renal failure (ARF group) and compared them with patients with noncomplicated AHA (non-ARF group). The medical records of 208 consecutive patients with AHA who were diagnosed between January 2003 and October 2008 were reviewed. We identified 15 patients (7.2%) with ARF associated with AHA. There were no differences between the ARF and non-ARF group with regard to gender and age. The peak value of alanine aminotransferase (ALT) (median: 6060 IU/L vs 1792 IU/L, P < 0.001), prothrombin time (PT) (International normalized ratio, median 1.72 vs 1.10, P < 0.001), and total bilirubin level (median: 9.6 mg/dL vs 6.3 mg/dL, P = 0.04) were significantly higher in the ARF than in the non-ARF group. Twelve patients (80%) recovered completely with haemodialysis (seven patients, 46.7%) or only conservative management (five patients, 33.3%), while one patient underwent liver transplantation because of fulminant hepatic failure, and two patients died because of fulminant hepatic failure. There were no deaths among patients with noncomplicated AHA in the non-ARF group. Five patients underwent kidney biopsy; two patients were diagnosed with acute tubular necrosis, two patients with acute interstitial nephritis with IgA nephropathy and one patient with acute tubulointerstitial nephritis. All patients in the ARF group had microscopic haematuria and proteinuria (100%vs 31.1%, P < 0.001). Urine sodium levels were more than 10 mEq/L in 10 patients. The findings of high urinary sodium concentrations, microscopic haematuria and proteinuria did not support the diagnosis of hepatorenal syndrome (HRS). Patients with AHA with ARF had higher ALT levels, more prolonged PTs, and higher total bilirubin levels. The prognosis for these patients was poorer than for those without ARF. However, the patients with ARF and nonfulminant AHA had recovered with proper treatment and should not be confused with patients that have HRS.

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Interstitial nephritis, acute renal failure in a patient with non-fulminant hepatitis A infection

Cited by 22 publications

References 0 publications

Clinical features and outcomes of acute kidney injury among patients with acute hepatitis A

Clinical features and outcomes of acute kidney injury among patients with acute hepatitis A

A Rare Presentation of Hepatitis A Infection with Extrahepatic Manifestations

Clinical features of acute renal failure associated with hepatitis A virus infection

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