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Late-Relapsing Hepatitis after Yellow Fever

One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepa...

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Autores principales: Rezende, Izabela Maurício, Pereira, Leonardo Soares, Fradico, Jordana Rodrigues Barbosa, Pascoal Xavier, Marcelo Antônio, Alves, Pedro Augusto, Campi-Azevedo, Ana Carolina, Speziali, Elaine, dos Santos, Lívia Zignago Moreira, Albuquerque, Natalia Soares, Penido, Indiara, Santos, Tayrine Araujo, Bom, Ana Paula Dinis Ano, da Silva, Andrea Marques Vieira, Fernandes, Camilla Bayma, Calzavara, Carlos Eduardo, Kroon, Erna Geessien, Martins-Filho, Olindo Assis, Teixeira-Carvalho, Andréa, Drumond, Betânia Paiva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077229/
https://www.ncbi.nlm.nih.gov/pubmed/32079143
http://dx.doi.org/10.3390/v12020222
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author Rezende, Izabela Maurício
Pereira, Leonardo Soares
Fradico, Jordana Rodrigues Barbosa
Pascoal Xavier, Marcelo Antônio
Alves, Pedro Augusto
Campi-Azevedo, Ana Carolina
Speziali, Elaine
dos Santos, Lívia Zignago Moreira
Albuquerque, Natalia Soares
Penido, Indiara
Santos, Tayrine Araujo
Bom, Ana Paula Dinis Ano
da Silva, Andrea Marques Vieira
Fernandes, Camilla Bayma
Calzavara, Carlos Eduardo
Kroon, Erna Geessien
Martins-Filho, Olindo Assis
Teixeira-Carvalho, Andréa
Drumond, Betânia Paiva
author_facet Rezende, Izabela Maurício
Pereira, Leonardo Soares
Fradico, Jordana Rodrigues Barbosa
Pascoal Xavier, Marcelo Antônio
Alves, Pedro Augusto
Campi-Azevedo, Ana Carolina
Speziali, Elaine
dos Santos, Lívia Zignago Moreira
Albuquerque, Natalia Soares
Penido, Indiara
Santos, Tayrine Araujo
Bom, Ana Paula Dinis Ano
da Silva, Andrea Marques Vieira
Fernandes, Camilla Bayma
Calzavara, Carlos Eduardo
Kroon, Erna Geessien
Martins-Filho, Olindo Assis
Teixeira-Carvalho, Andréa
Drumond, Betânia Paiva
author_sort Rezende, Izabela Maurício
collection PubMed
description One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepatitis, inflammatory or metabolic liver disease, and new infections caused by hepatotropic agents. Anti-YFV IgM, IgG and neutralizing antibodies were detected in different times, but no viremia. A liver biopsy was collected three months after YF onset and tested positive for YFV antigens and wild-type YFV-RNA (364 RNA-copies/gram/liver). Transaminases and bilirubin levels remained elevated for five months, and the arresting of symptoms persisted for six months after the acute YF onset. Several serum chemokines, cytokines, and growth factors were measured. A similar immune response profile was observed in the earlier phases of the disease, followed by more pronounced changes in the later stages, when transaminases levels returned to normal. The results indicated viral persistence in the liver and continual liver cell damage three months after YF onset and reinforced the need for extended follow-ups of YF patients. Further studies to investigate the role of possible viral persistence and the immune response causing relapsing hepatitis following YF are also necessary.
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spelling pubmed-70772292020-03-20 Late-Relapsing Hepatitis after Yellow Fever Rezende, Izabela Maurício Pereira, Leonardo Soares Fradico, Jordana Rodrigues Barbosa Pascoal Xavier, Marcelo Antônio Alves, Pedro Augusto Campi-Azevedo, Ana Carolina Speziali, Elaine dos Santos, Lívia Zignago Moreira Albuquerque, Natalia Soares Penido, Indiara Santos, Tayrine Araujo Bom, Ana Paula Dinis Ano da Silva, Andrea Marques Vieira Fernandes, Camilla Bayma Calzavara, Carlos Eduardo Kroon, Erna Geessien Martins-Filho, Olindo Assis Teixeira-Carvalho, Andréa Drumond, Betânia Paiva Viruses Case Report One patient presented hyporexia, asthenia, adynamia, and jaundice two months after acute yellow fever (YF) onset; plus laboratory tests indicating hepatic cytolysis and a rebound of alanine and aspartate transaminases, and total and direct bilirubin levels. Laboratory tests discarded autoimmune hepatitis, inflammatory or metabolic liver disease, and new infections caused by hepatotropic agents. Anti-YFV IgM, IgG and neutralizing antibodies were detected in different times, but no viremia. A liver biopsy was collected three months after YF onset and tested positive for YFV antigens and wild-type YFV-RNA (364 RNA-copies/gram/liver). Transaminases and bilirubin levels remained elevated for five months, and the arresting of symptoms persisted for six months after the acute YF onset. Several serum chemokines, cytokines, and growth factors were measured. A similar immune response profile was observed in the earlier phases of the disease, followed by more pronounced changes in the later stages, when transaminases levels returned to normal. The results indicated viral persistence in the liver and continual liver cell damage three months after YF onset and reinforced the need for extended follow-ups of YF patients. Further studies to investigate the role of possible viral persistence and the immune response causing relapsing hepatitis following YF are also necessary. MDPI 2020-02-17 /pmc/articles/PMC7077229/ /pubmed/32079143 http://dx.doi.org/10.3390/v12020222 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Rezende, Izabela Maurício
Pereira, Leonardo Soares
Fradico, Jordana Rodrigues Barbosa
Pascoal Xavier, Marcelo Antônio
Alves, Pedro Augusto
Campi-Azevedo, Ana Carolina
Speziali, Elaine
dos Santos, Lívia Zignago Moreira
Albuquerque, Natalia Soares
Penido, Indiara
Santos, Tayrine Araujo
Bom, Ana Paula Dinis Ano
da Silva, Andrea Marques Vieira
Fernandes, Camilla Bayma
Calzavara, Carlos Eduardo
Kroon, Erna Geessien
Martins-Filho, Olindo Assis
Teixeira-Carvalho, Andréa
Drumond, Betânia Paiva
Late-Relapsing Hepatitis after Yellow Fever
title Late-Relapsing Hepatitis after Yellow Fever
title_full Late-Relapsing Hepatitis after Yellow Fever
title_fullStr Late-Relapsing Hepatitis after Yellow Fever
title_full_unstemmed Late-Relapsing Hepatitis after Yellow Fever
title_short Late-Relapsing Hepatitis after Yellow Fever
title_sort late-relapsing hepatitis after yellow fever
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077229/
https://www.ncbi.nlm.nih.gov/pubmed/32079143
http://dx.doi.org/10.3390/v12020222
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