Mycoplasma pneumoniae-associated Hepatitis without Lung Involvement

Han Taek Jeong; Jae Young Oh; Jung Eun Song; Byung Seok Kim; Chang Hyeong Lee

doi:10.4166/kjg.2017.70.1.50

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Jeong, Oh, Song, Kim, and Lee: Mycoplasma pneumoniae-associated Hepatitis without Lung Involvement

Case Report

Korean J Gastroenterol 2017;70(1):50-53.

Published online: 4 October 2017

DOI: https://doi.org/10.4166/kjg.2017.70.1.50

Mycoplasma pneumoniae-associated Hepatitis without Lung Involvement

Han Taek Jeong, Jae Young Oh, Jung Eun Song, Byung Seok Kim, Chang Hyeong Lee

Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea

Correspondence to: Chang Hyeong Lee, Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea. Tel: +82-53-650-3000, Fax: +82-53-623-7507, E-mail: chlee1@cu.ac.kr

Received 2 May 2017 Revised 3 July 2017 Accepted 12 July 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mycoplasma pneumoniae (M. pneumoniae) is a major cause of community acquired respiratory infections. And it also causes a number of extrapulmonary manifestations including cardiovascular, dermatological, musculoskeletal, and hematological systems. But, acute hepatitis without lung involvement is rare in adults. Here, we report a case of 32-year-old man who presented with fever, chilling, myalgia, and headache. Biochemical analysis showed severely impaired liver function and leukopenia. Laboratory tests and liver biopsy demonstrated a hepatocellular pattern of M. pneumoniae-associated acute hepatitis. Clinical symptoms and laboratory parameters are improved rapidly under treatment with macrolide. Therefore, We recommend that phsycians should consider a possibility of M. pneumoniae infection in acute hepatitis without lung and extrapulmonary involvement, when other more frequent causes have been excluded.

Keywords: Mycoplasma pneumoniae, Hepatitis, Adult, Leukopenia

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Fig. 1.

Time course of liver function parameters during hospitalization period. The hospital day 1 means the first day the patient visited hospital. Arrow indicates start of macrolide therapy. Note the rapid regression of T-bil, WBC, and ALT level, while ALP level remains elevated. T-bil, total bilirubin; WBC, white blood cell count; ALT, alanine aminotransferase; ALP, alkaline phosphatase.

Fig. 2.

Microscopic finding of liver needle biopsy. The picture shows many lymphocytes infiltration (H&E, ×200).

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