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. 1997 Jul;41(1):121–124. doi: 10.1136/gut.41.1.121

Co-existence of hepatitis A and adult Reye's syndrome.

D R Duerksen 1, L D Jewell 1, A L Mason 1, V G Bain 1
PMCID: PMC1027239  PMID: 9274483

Abstract

Reye's syndrome is most frequently seen in children but has also been described in adults. This syndrome is usually associated with ingestion of 5-aminosalicylates (ASA) or infection with influenza A, influenza B, or varicella virus. A case of Reye's syndrome in a 47 year old, previously healthy woman precipitated by ingestion of ASA and acute hepatitis A virus infection is described. Reye's syndrome was diagnosed on the basis of her clinical course, and the presence of hepatic microvesicular steatosis and characteristic electron microscopic changes in the hepatocyte mitochondria. The diagnosis of hepatitis A was based on higher amino-transferase values than would be expected in Reye's syndrome alone, viral serology including the presence of hepatitis A IgM and the demonstration of hepatitis A virus RNA on liver biopsy by in situ hybridisation. Mitochondrial injury has been demonstrated in acute hepatitis A which, in addition to ASA, may have precipitated Reye's syndrome in this patient. The association between hepatitis A and Reye's syndrome has not been reported before. As hepatitis A virus infection is not sought routinely in patients with Reye's syndrome, the frequency of this association is unknown.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bove K. E., McAdams A. J., Partin J. C., Partin J. S., Hug G., Schubert W. K. The hepatic lesion in Reye's syndrome. Gastroenterology. 1975 Sep;69(3):685–697. [PubMed] [Google Scholar]
  2. Corkey B. E., Hale D. E., Glennon M. C., Kelley R. I., Coates P. M., Kilpatrick L., Stanley C. A. Relationship between unusual hepatic acyl coenzyme A profiles and the pathogenesis of Reye syndrome. J Clin Invest. 1988 Sep;82(3):782–788. doi: 10.1172/JCI113679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Forsyth B. W., Horwitz R. I., Acampora D., Shapiro E. D., Viscoli C. M., Feinstein A. R., Henner R., Holabird N. B., Jones B. A., Karabelas A. D. New epidemiologic evidence confirming that bias does not explain the aspirin/Reye's syndrome association. JAMA. 1989 May 5;261(17):2517–2524. [PubMed] [Google Scholar]
  4. Heubi J. E., Partin J. C., Partin J. S., Schubert W. K. Reye's syndrome: current concepts. Hepatology. 1987 Jan-Feb;7(1):155–164. doi: 10.1002/hep.1840070130. [DOI] [PubMed] [Google Scholar]
  5. Jansen R. W., Newbold J. E., Lemon S. M. Complete nucleotide sequence of a cell culture-adapted variant of hepatitis A virus: comparison with wild-type virus with restricted capacity for in vitro replication. Virology. 1988 Apr;163(2):299–307. doi: 10.1016/0042-6822(88)90270-x. [DOI] [PubMed] [Google Scholar]
  6. Mason A., Wick M., White H., Perrillo R. Hepatitis B virus replication in diverse cell types during chronic hepatitis B virus infection. Hepatology. 1993 Oct;18(4):781–789. doi: 10.1002/hep.1840180406. [DOI] [PubMed] [Google Scholar]
  7. Meythaler J. M., Varma R. R. Reye's syndrome in adults. Diagnostic considerations. Arch Intern Med. 1987 Jan;147(1):61–64. [PubMed] [Google Scholar]
  8. Rahaman S. M., Chira P., Koff R. S. Idiopathic autoimmune chronic hepatitis triggered by hepatitis A. Am J Gastroenterol. 1994 Jan;89(1):106–108. [PubMed] [Google Scholar]
  9. Schaffner F., Dienstag J. L., Purcell R. H., Popper H. Chimpanzee livers after infection with human hepatitis viruses A and B: Ultrastructural studies. Arch Pathol Lab Med. 1977 Mar;101(3):113–117. [PubMed] [Google Scholar]
  10. Schwarz K. B., Zieber T. M., Sharma S., Clemens M. G., Seligman P. Activated THP-1 cells depress mitochondrial respiration in Hep G2 cells infected with influenza B virus. Mol Cell Probes. 1994 Oct;8(5):345–351. doi: 10.1006/mcpr.1994.1050. [DOI] [PubMed] [Google Scholar]
  11. Shimizu Y. K., Shikata T., Beninger P. R., Sata M., Setoyama H., Abe H., Tanikawa K. Detection of hepatitis A antigen in human liver. Infect Immun. 1982 Apr;36(1):320–324. doi: 10.1128/iai.36.1.320-324.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Treem W. R., Shoup M. E., Hale D. E., Bennett M. J., Rinaldo P., Millington D. S., Stanley C. A., Riely C. A., Hyams J. S. Acute fatty liver of pregnancy, hemolysis, elevated liver enzymes, and low platelets syndrome, and long chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency. Am J Gastroenterol. 1996 Nov;91(11):2293–2300. [PubMed] [Google Scholar]
  13. Van Coster R. N., De Vivo D. C., Blake D., Lombes A., Barrett R., DiMauro S. Adult Reye's syndrome: a review with new evidence for a generalized defect in intramitochondrial enzyme processing. Neurology. 1991 Nov;41(11):1815–1821. doi: 10.1212/wnl.41.11.1815. [DOI] [PubMed] [Google Scholar]
  14. Vento S., Garofano T., Di Perri G., Dolci L., Concia E., Bassetti D. Identification of hepatitis A virus as a trigger for autoimmune chronic hepatitis type 1 in susceptible individuals. Lancet. 1991 May 18;337(8751):1183–1187. doi: 10.1016/0140-6736(91)92858-y. [DOI] [PubMed] [Google Scholar]

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