[A man who contracted hepatitis E in the Netherlands]. / Een man met in Nederland opgelopen hepatitis E.

A 55-year-old man was admitted to our hospital because of malaise, jaundice en cholestatic liver function impairment, 4 days after his return from vacation in Surinam. Serological tests were positive for IgG and IgM antibodies to hepatitis E virus (HEV) and serum PCR was positive, consistent with HEV infection. The infection was acquired in the Netherlands and not abroad, considering the incubation period. The patient recovered spontaneously. HEV infection is rare in the Netherlands and is associated with travel to tropical or subtropical areas. The virus is transmitted by the faecal-oral route through contaminated water or food. Since 2000 there have been cases reported in the Netherlands, without any association with travelling abroad and in which the infection might be related to zoonotic transmission. The diagnosis is primarily based upon serologic tests for the detection of IgM and IgG antibodies to HEV in serum confirmed by immunoblot. It is important that HEV infection is considered in patients with acute hepatitis in whom no other cause can be found for hepatitis, even without any travel history to endemic areas.

Watery diarrhoea: an unusual manifestation of breast cancer.

Analysis of an 83-year-old male presenting with diarrhoea showed secretory diarrhoea. serum levels of gastrin and pancreatic polypeptide were elevated. Somatostatin-receptor scintigraphy revealed a hot spot in the left thoracic wall and subsequently, breast adenocarcinoma with neuroendocrine differentiation was diagnosed. Postoperatively, the patient made an uneventful recovery. The relationship between the clinical picture, the results of pathological examination and hormonal analysis is discussed and put into perspective.