Korean J Gastroenterol.  2017 Jul;70(1):50-53. 10.4166/kjg.2017.70.1.50.

Mycoplasma pneumoniae-associated Hepatitis without Lung Involvement

• Jeong HT
• Oh JY
• Song JE
• Kim BS
• Lee CH

• KMID: 2390785
• DOI: http://doi.org/10.4166/kjg.2017.70.1.50

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.

Keyword

Mycoplasma pneumoniae; Hepatitis; Adult; Leukopenia

MeSH Terms

Adult
Biopsy
Fever
Headache
Hepatitis*
Humans
Leukopenia
Liver
Lung*
Myalgia
Mycoplasma pneumoniae
Mycoplasma*
Pneumonia
Pneumonia, Mycoplasma
Respiratory Tract Infections

Figure

• 

  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).

Reference

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