Journal List > Korean J Gastroenterol > v.55(3) > 1006644

Ko, Yoo, Hyun, Chung, Park, Kim, and Jeon: A Case of Pleural Effusion Associated with Acute Hepatitis A

Abstract

Hepatitis A virus (HAV) infection is common in developing countries, including Korea. It can be accompanied by extrahepatic complications such as renal failure, arthritis, and vasculitis. Pleural effusion is a very rare complication of HAV infection, which has been reported usually in children, and has benign clinical courses. Here we report a case of pleural effusion with ascites which occurred in an adult hepatitis A patient. A 26-year-old-wom-an presented generalized myalgia and fever and was diagnosed as acute hepatitis A. Despite of the improvement of laboratory findings, fever and cough persisted. Pleural effusion newly appeared on the serial chest radiologic images. After the fever settled down, the pleural effusion resolved spontaneously at 13th day of admission.

REFERENCES

1. Jeong SH. Current status and vaccine indication for hepatitis A virus infection in Korea. Korean J Gastroenterol. 2008; 51:331–337.
2. Song YB, Lee JH, Choi MS, et al. The age-specific seroprevalence of hepatitis A virus antibody in Korea. Korean J Hepatol. 2007; 13:27–33.
3. Lee EJ, Kwon SY, Seo TH, et al. Clinical features of acute hepatitis A in recent two years clinical features of acute hepatitis A in recent two years. Korean J Gastroenterol. 2008; 52:298–303.
4. Tong MJ, el-Farra NS, Grew MI. Clinical manifestations of hepatitis A: recent experience in a community teaching hospital. J Infect Dis. 1995; 171:15–18.
crossref
5. Gordon SC, Reddy KR, Schiff L, Schiff ER. Prolonged intrahepatic cholestasis secondary to acute hepatitis A. Ann Intern Med. 1984; 101:635–637.
crossref
6. Sjogren MH. Hepatitis A. Feldman M, Friedman LS, Brandt LJ, Sleisenger MH, editors. eds.Sleisenger & Fordtran's gastrointestinal and liver disease. Volume 2. 8th ed.Philadelphia, PA: Saunders Elsevier;2006. p. 1642.
crossref
7. Kim DI, Park JO, Kim CH. A case of pleural effusion associated with acute hepatitis A. Korean J Pediatr Gastroenterol Nutr. 2005; 48:243–246.
8. Hong WS, Kim CY. Seroepidemiology of type A and type B hepatitis in Seoul area. Korean J Intern Med. 1982; 25:19–26.
9. Jeong SH. Current status and vaccine indication for hepatitis A virus infection in Korea. Korean J Gastroenterol. 2008; 51:331–337.
10. Willner IR, Uhl MD, Howard SC, Williams EQ, Riely CA, Waters B. Serious hepatitis A: an analysis of patients hospitalized during an urban epidemic in the United States. Ann Intern Med. 1998; 128:111–114.
crossref
11. Alhan E, Yildizdaş D, Ypicioğ lu H, Necmi A. Pleural effusion associated with acute hepatitis A infection. Pediatr Infect Dis J. 1999; 18:1111–1112.
crossref
12. Kurt ANC, Bulut Y, Mehmet T, et al. Pleural effusion associated with hepatitis A. J Pediatr Inf. 2008; 2:25–26.
13. Selimoğ lu MA, Ziraatci O, Tan H, Ertekin V. A rare complication of Hepatitis A: pleural effusion. J Emerg Med. 2004; 28:229–230.
14. Bukulmez A, Koken R, Melek H, Dogru O, Ovali F. Pleural effusion: a rare complication of hepatitis A. Indian J Med Microbiol. 2008; 26:87–88.
crossref
15. Tesovic G, Vukelić D, Vuković B, Benić B, Bozinovi D. Pleural effusion associated with acute hepatitis A infection. Pediatr Infect Dis J. 2000; 19:585–586.
crossref
16. Gü rkan F. Ascites and pleural effusion accompanying hepatitis A infection in a child. Clin Microbiol Infect. 2000; 6:286–287.
17. Vaidya P, Kadam C. Hepatitis A: an unusual presentation. Indian Pediatr. 2003; 40:910–911.
18. Simmons WW, Warren RE. Eosinophilic pleural effusion associated with recovery from viral hepatitis A. J Clin Gastroenterol. 1994; 19:143–145.
crossref

Fig. 1.
Chest radiography. Right pleural effusion appeared at the 6th day in hospital (posteroanterior view).
kjg-55-198f1.tif
Fig. 2.
Computer tomography. Right side pleural effusion was observed (A). Minimal amount of left side pleural effusion and ascites was observed (B).
kjg-55-198f2.tif
Table 1.
Clinical Features of Pleural Effusion Combined with Hepatitis A
Author Sex Age Location Other complication Pleural effusion study Prognosis
Case F 24 Right Ascites Exudate, Culture (−) Recovered on day 15
Kim7 F 12 Right Ascites NA Recovered on day 8
Willner10 F 14 NA Pericardial effusion NA Recovered
Alhan11 F 12 Right None Exudate, IgM anti-HAV (+), Culture (−) Recovered on day 7
Alhan11 M 5 Right None Exudate, IgM anti-HAV (+), Culture (−) Recovered on day 5
Kurt12 M 6 Right None Exudate, HAV RNA (+), Culture (−) Recovered on day 10
Selimoglu13 M 8 Right None Transudate Recovered on day 7
Bukulmez14 F 7 Right None NA Recovered on day 12
Tesovic15 M 3 Right None Transudate Recovered on day 7
but expired due to liver failure
Gurkan16 M 4 Bilateral Ascites NA Recovered on day 15
Parasad17 M 5 Left Ascites NA Recovered on day 14
Simmons18 F 24 Right None Eosinophilic exudates, Culture (−) Recovered on day 14

NA: data not available.

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