CASE HISTORY – November 2013

Acute E virus hepatitis. A case report

Authors: Tiina Prükk, Svetlana Proshkina, Rita Pihlak

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Hepatitis E is endemic in many countries where it causes high morbidity. In industrialised countries it is a rare disease which is largely confined to travellers returning from endemic areas. Autochthonous hepatitis E in developed countries is more common than was previously recognised.

A 48-year- old male patient was admitted to the department of infectious diseases of internal medicine, University of Tartu, in July 2012 with suspicion of acute hepatitis. He had fever 390C, nausea, vomiting and cough. Some days earlier he had noticed dark urine. Laboratory findings for acute hepatitis showed moderate hyperbilirubinaemia and high level of aminotranspherases as well as of ALP and GGT but all tests for hepatitis A (anti-HAV IgM), B (HBsAg, anti-HBV IgM) and C (anti-HCV) virus markers where negative. Tests for autoimmune hepatitis (ANA, SMA, ANKA) where negative as well. Then we tested the patient`s sera for anti-HEV IgM and anti-HEV IgG and both results where positive. In November we repeated serology and, as a result, anti-HEV IgM was negatiive and anti-HEV IgG was positive.

It is the first case of acute hepatitis E diagnosed in Estonia.