A Rare Case of Fulminant Liver Failure due to Hepatitis A Treated with Plasma Exchange and Continuous Kidney Replacement Therapy
Year: 2025
Type: article
Study design: Case Report
Abstract: Intravenous N-acetylcysteine infusion was initiated and continued for 72 hours.Hepatitis A immunoglobulin M (IgM) was positive.The next day, the patient's condition deteriorated with worsening encephalopathy, necessitating intubation for airway Aim A n d BAckgroundHyperacute liver failure is a condition associated with high mortality, between 50 and 75% in India. 1 It rarely occurs due to hepatitis A (incidence <1%). 2 We report a case of hyperacute liver failure due to hepatitis A, which was treated with plasma exchange and continuous kidney replacement therapy (CKRT). cAse descriptionA 33-year-old male presented with a 1-month history of intermittent fever, relieved transiently by paracetamol.Over the past week, the fever had become persistent and high-grade, accompanied by yellowish discoloration of the eyes for 3 days and confusion for 1 day.There was no history of hepatotoxic drug use or alternative medication intake.He was initially admitted to another facility with severe restlessness and deranged liver function tests.Hepatitis markers (B, C, and E) were negative.Due to worsening symptoms, he was referred to this center for further management.On admission, the patient was icteric but hemodynamically stable.He was slightly confused.Arterial blood gas analysis revealed respiratory alkalosis with elevated lactate.Liver function tests showed severe transaminitis, mixed hyperbilirubinemia, and an international normalized ratio (INR) of 7.39 (Table 1).
Authors: Arghya Majumdar, Chandan Biswas, Simmy Tiwari, Arjun Talapatra, Kushan Sengupta
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411570613