만성B형 간염 환자에서 발생한 A형 간염에 의한 다발성 장기부전 1예
A Case of Multiple Organ Failure Complicating Hepatitis A Virus Superinfection in a Chronic Hepatitis B Patient
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초록
A형 간염 바이러스는 세계적으로 바이러스성 간염의 주요한 원인이다. 최근 우리나라에서는 젊은 성인에서의 A형 간염이 증가하고 있다. A형 간염은 드물게 전격성 간염, 급성 췌장염, 급성 신부전을 일으킨다. 저자들은 만성 B형 간염 환자가 A형 간염 바이러스 중복감염에 의해 전격성 간염, 급성 췌장염, 급성 신부전의 다발성 장기 부전을 보인 증례를 경험하였다. 38세 남자 환자가 열감, 근육통이 있어 내원하였다. 초기에 의식이 명료하였으나 의식이 혼탁해지고 급성 신부전, 급성 췌장염이 발생하였다. 환자는 지속적 신대체 요법과 보존적 치료를 받았으며, 다발성 장기 부전에서 완전히 호전되었다. 특히 기저 간 질환이 있는 환자에서 A형 간염의 여러 합병증에 대한 주의를 기울여야 할 것으로 생각된다.
Abstract
Hepatitis A virus is a major cause of viral hepatitis worldwide. The prevalence of hepatitis A in young adults has recently been increasing in Korea. Hepatitis A infection rarely complicates fulminant hepatitis, acute pancreatitis, and acute renal failure. We experienced a case of multiple organ failure involving fulminant hepatitis, acute pancreatitis, and acute renal failure complicating a hepatitis A superinfection in a chronic hepatitis B patient. The patient was a 38yearold man who presented with febrile sense and myalgia. He was initially alert, but became confused and developed acute renal failure and acute pancreatitis. He received continuous renal replacement therapy and conservative treatment and completely recovered from the multiple organ failure. It is important to consider a variety of potential complications in hepatitis A patients, especially in those with underlying chronic liver disease. (Korean J Med 2011;80:S111-S116)
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