A case of cholestatic hepatitis caused by visceral herpes zoster

doi:10.3877/cma.j.issn.1674-1358.2018.05.018

Abstract

Abstract:

Objective

To improve the level of clinical diagnosis and treatment of visceral herpes zoster.

Methods

A case of 72 years old male paitents, with visceral herpes zoster complicated with severe persistent upper abdominal pain and progressive jaundice was reported.

Results

After antiviral treatment, the herpes skin lesions healed but the condition repeated. Liver biopsy showed that virus inclusion bodies were still found in the liver cells and cholestasis was observed. Immunohistochemistry showed positive staining for herpes zoster virus. Visceral herpes zoster was healed after long-term antiviral treatment.

Conclusion

The antiviral treatment of visceral herpes zoster should be extended.

Key words: Varicella zoster virus, Cholestatic jaundice, Antiviral therapy

Fei Qiao, Ming Shao, Xiangtao Xu. A case of cholestatic hepatitis caused by visceral herpes zoster[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(05): 514-517.

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References 20

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临床资料		9月18日	9月28日	9月30日	10月14日	10月22日	10月27日	10月31日	11月10日	11月21日	12月9日	12月30日
病程(d)		5	17	20	36	42	47	50	54	61	89	110
用药		?	?	?	?	?	?	?	?	?	?	?
甲强龙		?	?	?	√	√	√	×	?	?	?	?
更昔洛韦		?	?	√	×	?	?	√	√	√	×	?
阿昔洛韦		?	?	?	?	?	?	?	?	?	√	√
实验室指标		?	?	?	?	?	?	?	?	?	?	?
?	Hb(g/dl)	11.1	10.4	10.4	8.0	8.5	8.1	9.0	10.0	10.1	9.6	10.3
?	WBC(× 10^?3/mm³)	3.5	6.86	6.4	4.56	6.53	5.67	7.0	6.17	6.07	3.48	4.16
?	PLT(× 10^?3/mm³)	60	183	188	164	118	108	94	113	103	144	157
?	ALT(U/L)	146	304	213	249	217	187	190	134	107	73	83
?	AST(U/L)	189	282	138	200	175	131	103	64	53	79	58
?	AKP(U/L)	525	875	733	492	435	355	391	332	305	556	330
?	GGT(U/L)	328	775	915	535	587	662	723	680	613	555	510
?	TBil(μmol/L)	88.5	224.1	413	420	378	401	430	362	303	171	93
?	DBil(μmol/L)	71.2	135	240	301	392	307	288	263	221	123	74
?	ALB(g/L)	24.4	34.7	30	38.6	37.2	35.6	33.2	33.8	32.5	27.4	29.5
?	球蛋白(g/L)	25.6	25.7	32.5	30.3	19.4	20.1	20.1	23.3	22	24.4	22.8
?	CRP(mg/L)	196	137	ND	ND	2	3	ND	3	6	4	1
?	PT(S)	13.6	13.9	ND	14.5	13.7	13.8	ND	12.5	13.2	13.6	12.4
?	INR	1.11	1.04	ND	1.21	1.12	1.13	ND	1.0	1.0	1.04	0.92
?	D二聚体( mg/L)	1.19	1.91	ND	0.71	0.57	0.4	ND	0.34	0.26	0.1	0.42
?	粪便隐血	+	+	+	ND	ND	ND	ND	ND	ND	ND	ND
?	尿隐血	+++	+	+	ND	ND	ND	ND	ND	ND	ND	ND

临床资料		9月18日	9月28日	9月30日	10月14日	10月22日	10月27日	10月31日	11月10日	11月21日	12月9日	12月30日
病程(d)		5	17	20	36	42	47	50	54	61	89	110
用药		?	?	?	?	?	?	?	?	?	?	?
甲强龙		?	?	?	√	√	√	×	?	?	?	?
更昔洛韦		?	?	√	×	?	?	√	√	√	×	?
阿昔洛韦		?	?	?	?	?	?	?	?	?	√	√
实验室指标		?	?	?	?	?	?	?	?	?	?	?
?	Hb(g/dl)	11.1	10.4	10.4	8.0	8.5	8.1	9.0	10.0	10.1	9.6	10.3
?	WBC(× 10^?3/mm³)	3.5	6.86	6.4	4.56	6.53	5.67	7.0	6.17	6.07	3.48	4.16
?	PLT(× 10^?3/mm³)	60	183	188	164	118	108	94	113	103	144	157
?	ALT(U/L)	146	304	213	249	217	187	190	134	107	73	83
?	AST(U/L)	189	282	138	200	175	131	103	64	53	79	58
?	AKP(U/L)	525	875	733	492	435	355	391	332	305	556	330
?	GGT(U/L)	328	775	915	535	587	662	723	680	613	555	510
?	TBil(μmol/L)	88.5	224.1	413	420	378	401	430	362	303	171	93
?	DBil(μmol/L)	71.2	135	240	301	392	307	288	263	221	123	74
?	ALB(g/L)	24.4	34.7	30	38.6	37.2	35.6	33.2	33.8	32.5	27.4	29.5
?	球蛋白(g/L)	25.6	25.7	32.5	30.3	19.4	20.1	20.1	23.3	22	24.4	22.8
?	CRP(mg/L)	196	137	ND	ND	2	3	ND	3	6	4	1
?	PT(S)	13.6	13.9	ND	14.5	13.7	13.8	ND	12.5	13.2	13.6	12.4
?	INR	1.11	1.04	ND	1.21	1.12	1.13	ND	1.0	1.0	1.04	0.92
?	D二聚体( mg/L)	1.19	1.91	ND	0.71	0.57	0.4	ND	0.34	0.26	0.1	0.42
?	粪便隐血	+	+	+	ND	ND	ND	ND	ND	ND	ND	ND
?	尿隐血	+++	+	+	ND	ND	ND	ND	ND	ND	ND	ND

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