Abstract
Myocarditis, defined as the inflammation of myocardial tissue has many causes which may be viral, metabolic or bacterial in origin. In this case we report a patient aged 22 years who was admitted with presenting complains of loss of consciousness, generalized muscle rigidity and yellowish discoloration of skin. During the course of his hospital stay, patient developed signs ofmyocarditis and later died of hypotensive shock. Viral serology was positive for the presence of hepatitis E virus (HEV), a rare cause of myocarditis. HEV infection can range from asymptomatic disease course to fulminant hepatitis but in rare cases it has been found to be a cause of myocarditis. This is so far the sixth case of hepatitis E induced myocarditis.
Highlights
Hepatitis E (HEV) virus is an important cause of morbidity and mortality and constitutes a significant public health problem[1]
Symptoms of hepatitis E virus (HEV) infection ranges from asymptomatic to fulminant hepatitis, which is most common in pregnant women
Our patient contracted an acute HEV infection causing acute fulminant hepatitis leading to hepatic encephalopathy, coma and loss of consciousness
Summary
Hepatitis E (HEV) virus is an important cause of morbidity and mortality and constitutes a significant public health problem[1]. Laboratory parameters at that time revealed, altered liver function tests (LFTs) with serum glutamic pyruvic transaminase (SGPT) 1160 u/L (reference range, 7–56 u/L); aspartate aminotransferase (AST) 225 u/L (reference range, 10–40 u/L); gamma-glutamyltransferase (GGT) 51 u/L (reference range, 9–50 u/L); alkaline phosphatase (ALP) 372 u/L (reference range, 150–480 u/L); serum albumin 4.2 g/dL (reference range, 3.5–5.5 g/dL); total bilirubin 4 mg/dL (reference range, 0.1–1.2 mg/dL); platelet time (PT) 13 seconds (reference range, 11–14 seconds); and international normalized ratio (INR) 13 seconds (reference range, 0.9–1.2 seconds) His blood urea was 61 mg/dl (Reference range, 7–20 mg/dL), serum creatinine of 1.64 (reference range, 0.6–1.2 mg/dL), with a normal serum electrolyte panel. More specific investigations were planned but could not be performed post-mortem
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