J Liver Cancer.  2019 Mar;19(1):55-58. 10.17998/jlc.19.1.55.

Hepatic Failure Due to Hepatitis E Virus Infection in a Patient with Necrotic Hepatocellular Carcinoma

• Kim JH
• Doh YS
• Jang JW
• Kang MS
• Kim NM
• Kim SH
• Baek IH
• Jung SH

• KMID: 2448277
• DOI: http://doi.org/10.17998/jlc.19.1.55

Abstract

In patients with hepatocellular carcinoma (HCC) or liver cirrhosis (LC) accompanied by hepatitis E virus (HEV) infection, hepatic failure often leads to debility. Here, we report about a 63-year-old man with alcoholic LC who was referred to our hospital with jaundice and abdominal distension 10 days earlier. Abdominal computed tomography showed necrotic HCC accompanied by left lobe shrinkage without tumor progression. Laboratory and imaging findings revealed no acute infection focus. The patient reported no herbal medicine or alcohol consumption, and there was no evidence of acute viral hepatitis. One month later, HEV immunoglobulin M positivity was confirmed, and deterioration of liver function due to HEV infection was suspected. The patient often ate raw oysters and sashimi, as well as boar meat, which is a well-known risk food for HEV infection. His umbilical hernia deteriorated due to tense ascites and infection by skin abrasion. The patient progressed to hepatorenal syndrome and eventually died. Liver function preservation is important when treating HCC patients. Therefore, clinicians should pay more attention to the prevention of HEV and others causes of direct liver injury.

Keyword

Hepatocellular carcinoma; Regression; Hepatitis E virus; Liver failure

MeSH Terms

Alcohol Drinking
Alcoholics
Ascites
Carcinoma, Hepatocellular*
Hepatitis E virus*
Hepatitis E*
Hepatitis*
Hepatorenal Syndrome
Herbal Medicine
Hernia, Umbilical
Humans
Immunoglobulin M
Jaundice
Liver
Liver Cirrhosis
Liver Failure*
Meat
Middle Aged
Ostreidae
Skin
Transcutaneous Electric Nerve Stimulation
Immunoglobulin M

Figure

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  Figure 1. Abdominal computed tomography showing a 2.4 cm, round, low-attenuating mass in segment VIII (thick arrows) as well as main, left, and right portal vein thrombus (edged arrows).

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