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L-Ornithine-L-Aspartate and Intermittent Renal Replacement Therapy in Fulminant Hepatitis A: A Case Report
Journal of Renal and Hepatic Disorders ; 7(1):2833, 2023.
Article in English | EMBASE | ID: covidwho-2317777
Hepatitis A is a common viral infection worldwide that is transmitted via the fecal-oral route. Since the introduction of an efficient vaccine, the incidence of infection has decreased but the number of cases has risen due to widespread community outbreaks among unimmunized individuals. Classic symptoms include fever, malaise, dark urine, and jaundice, and are more common in older children and adults. People are often most infectious 14 days prior to and 7 days following the onset of jaundice. We will discuss the case of a young male patient, diagnosed with acute hepatitis A, leading to fulminant hepatitis refractory to conventional therapy and the development of subsequent kidney injury. The medical treatment through the course of hospitalization was challenging and included the use of L-ornithine-L-aspartate and prolonged intermittent hemodialysis, leading to a remarkable outcome. Hepatitis A is usually self-limited and vaccine-preventable;supportive care is often sufficient for treatment, and chronic infection or chronic liver disease rarely develops. However, fulminant hepatitis, although rare, can be very challenging to manage as in the case of our patient.Copyright © 2023 The Author(s).
a case report; continuous renal replacement therapy; fulminant hepatitis; hepatitis A; intermittent renal replacement therapy; L-ornithine-L-aspartate; abdominal radiography; abdominal tenderness; acute hepatitis A/th [Therapy]; acute kidney failure/dt [Drug Therapy]; acute kidney failure/th [Therapy]; add on therapy; adult; antibiotic therapy; antibody titer; article; autoimmune hepatitis/dt [Drug Therapy]; basal ganglion; brain cortex; brain edema; case report; clinical article; clinical decision making; clinical outcome; Clostridium difficile infection; computer assisted tomography; continuous infusion; coronavirus disease 2019/dt [Drug Therapy]; critically ill patient; decreased appetite; disease duration; drug pulse therapy; drug use; dyslipidemia/dt [Drug Therapy]; echography; electroencephalogram; erosive gastritis; extended daily dialysis; extubation; eye jaundice; fever/dt [Drug Therapy]; follow up; fulminant hepatitis/co [Complication]; fulminant hepatitis/di [Diagnosis]; fulminant hepatitis/dt [Drug Therapy]; fulminant hepatitis/th [Therapy]; gastroscopy; general condition deterioration; general condition improvement; Glasgow coma scale; hematemesis/dt [Drug Therapy]; hemodialysis; hepatic encephalopathy/dt [Drug Therapy]; Hepatitis A virus; hepatomegaly; hospital acquired pneumonia/dt [Drug Therapy]; hospital admission; hospital to home transition; hospitalization; human; intensive care unit; international normalized ratio; intubation; jaundice; laboratory test; length of stay; liver function test; liver transplantation; male; nausea; neuroimaging; nuclear magnetic resonance imaging; nutritional support; partial thromboplastin time; patient monitoring; pelvis radiography; physical examination; physiotherapy; prothrombin time; pruritus/dt [Drug Therapy]; psychological care; refractory disease; rehydration; supportive care need; thalamus; thorax radiography; treatment duration; watery stool/dt [Drug Therapy]; acetylcysteine/dt [Drug Therapy]; acetylcysteine/pv [Special Situation for Pharmacovigilance]; antinuclear antibody/ec [Endogenous Compound]; ezetimibe plus rosuvastatin/dt [Drug Therapy]; fresh frozen plasma/dt [Drug Therapy]; fresh frozen plasma/pv [Special Situation for Pharmacovigilance]; immunoglobulin M/ec [Endogenous Compound]; infusion fluid/dt [Drug Therapy]; infusion fluid/iv [Intravenous Drug Administration]; infusion fluid/tm [Unexpected Outcome of Drug Treatment]; lactulose/dt [Drug Therapy]; lactulose/tm [Unexpected Outcome of Drug Treatment]; methylprednisolone/dt [Drug Therapy]; methylprednisolone/iv [Intravenous Drug Administration]; ornithine aspartate/dt [Drug Therapy]; ornithine aspartate/pv [Special Situation for Pharmacovigilance]; paracetamol/dt [Drug Therapy]; piperacillin plus tazobactam/dt [Drug Therapy]; piperacillin plus tazobactam/iv [Intravenous Drug Administration]; piperacillin plus tazobactam/pv [Special Situation for Pharmacovigilance]; proton pump inhibitor/dt [Drug Therapy]; proton pump inhibitor/iv [Intravenous Drug Administration]; rifaximin/dt [Drug Therapy]; rifaximin/tm [Unexpected Outcome of Drug Treatment]; SARS-CoV-2 vaccine/dt [Drug Therapy]; ursodeoxycholic acid/dt [Drug Therapy]; ursodeoxycholic acid/po [Oral Drug Administration]; vancomycin/dt [Drug Therapy]; vancomycin/po [Oral Drug Administration]; vancomycin/pv [Special Situation for Pharmacovigilance]; nasogastric tube; ventilator

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Case report Language: English Journal: Journal of Renal and Hepatic Disorders Year: 2023 Document Type: Article





Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Case report Language: English Journal: Journal of Renal and Hepatic Disorders Year: 2023 Document Type: Article