ABSTRACT
RESUMEN El virus de la hepatitis E tiene una amplia distribución a nivel mundial. Se presentaron dos casos clínicos en la provincia de Matanzas, con diagnóstico confirmado de hepatitis E mediante la determinación del ARN viral en heces fecales congeladas; a pesar de proceder de áreas de salud distantes, coincidieron en el mismo período de tiempo. El primero de ellos, una gestante asintomática diagnosticada fortuitamente a partir de elevación de enzimas hepáticas de citolisis. Evolucionó satisfactoriamente sin repercusión en su bienestar materno, trasmisión fetal, ni complicaciones perinatales. El segundo, una paciente portadora de síndrome metabólico, con evolución tórpida de su cuadro infeccioso viral, que la llevó a la insuficiencia hepática y a la muerte. Con estos casos se reflejó el amplio espectro de esta enfermedad en cuanto a formas clínicas de presentación y evolución. Se demostró que pueden ocurrir complicaciones en cualquier grupo poblacional, de ahí la importancia de considerarla en el diagnóstico diferencial de las enfermedades infecciosas hepáticas (AU).
ABSTRACT Hepatitis E virus is widely distributed around the world. Two clinical cases occurring in the province of Matanzas were presented, both with diagnosis of E hepatitis confirmed through viral RNA determination in frozen stool; although patients came from faraway health areas, they coincided in the same time period. The first patient, a pregnant asymptomatic woman, was incidentally diagnosed due to an increase of cytolysis liver enzymes. Her evolution was satisfactory without repercussion on maternal wellbeing, fetal transmission, nor perinatal complications. The second patient, a metabolic syndrome carrier, had torpid evolution of a viral infectious disease leading her to liver failure and death. These cases highlighted the wide range of this disease according to its clinical forms of presentation and evolution. It was showed that complications may occur in any population group, in consequence it is important to consider this disease when making the differential diagnosis of liver infectious diseases (AU).
Subject(s)
Humans , Male , Female , Clinical Evolution/classification , Hepatitis E/therapy , Hepatitis E/rehabilitation , Hepatitis E/epidemiology , Metabolic Syndrome/complications , Pregnant Women , Hepatic Insufficiency/diagnosis , Hepatic Insufficiency/therapySubject(s)
Humans , Hepatitis, Viral, Human/diagnosis , Hepacivirus/pathogenicity , Hepatitis A/diagnosis , Hepatitis A/therapy , Hepatitis B/diagnosis , Hepatitis B/therapy , Hepatitis C/diagnosis , Hepatitis C/therapy , Hepatitis Delta Virus/pathogenicity , Hepatitis D/diagnosis , Hepatitis D/therapy , Hepatitis E virus/pathogenicity , Hepatitis E/diagnosis , Hepatitis E/therapy , Hepatovirus/pathogenicityABSTRACT
Os autores revisam os diversos aspectos concernentes a hepatite pelo virus E. Consideram que a mesma e uma forma frequente em paises em desenvolvimento, transmitindo-se principalmento pela via fecal-oral. E causada por um virus RNA poliadenilado de cadeia simples e sentido positivo, o virus da hepatite E. Clinicamente manifesta-se de forma semelhante a uma doenca aguda icterica autolimitada, emprestando, no entanto, um mau prognostico quando acomete gestantes. Seu diagnostico e sorologico atraves da deteccao de anticorpos das classes IgG e IgM por tecnicas de enzimoimunoensaios e de Western blot. Nao ha tratamento especifico e a prevencao fundamenta-se no saneamento basico