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Fulminant Hepatitis E in a Woman Taking Oral Contraceptive Medication
We describe a fulminant autochthonous hepatic failure caused by hepatitis E (HEV) in a patient admitted in our hospital for liver-transplant evaluation. The only risk factor recorded for this severe course was the use of oral contraceptives that are known to mimic a hormonal status similar to pregnancy. The diagnosis was based on the presence of IgG and IgM anti-HEV in the serum of the patient and confirmed by the isolation of a strain of HEV genotype 3f from a blood sample obtained the fourth day after hospital admission. HEV genotype 3 is present in human and swine populations in Spain. The patient began to recover while waiting for a liver transplant. To our knowledge, this is the first report of fulminant hepatitis E in a non-pregnant European patient on oral contraceptives.
Author Notes
Authors' addresses: Maria Luisa Mateos Lindemann and Mario Rodríguez Domínguez, Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. Javier Graus Morales and Fernando García de la Hoz, Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. Salceda Fernández-Barredo and Maria Teresa Pérez Gracia, Microbiology, CEU Cardenal Herrera University Moncada, Valencia, Spain. Philippe Halfon, Laboratoire ALPHABIO, Hopital Ambroise Paré, Marseille, France.