Abstract
We present a case of severe exacerbation of hepatitis after short-term corticosteroid therapy for chronic inflammatory demyelinating polyneuropathy (CIPD) with "latent" chronic hepatitis B showing no HBV-related antigens and antibodies. After corticosteroid pulse therapy for CIPD, the patient had severe exacerbation of hepatitis twice. Although she did not show any hepatitis B virus (HBV)-related antigens or antibodies, sequences of HBV were detected in serum and liver by a nested polymerase chain reaction. A sequence analysis of HBV at the second exacerbation showed that the G-to-A point mutation at nucleotide 1896 that converted codon 28 from tryptophan (TGG) to a stop codon (TAG) in the precore region resulted in amino acid change, which has been frequently observed in fulminant hepatitis and severe hepatitis in Japan.
MeSH terms
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Adrenal Cortex Hormones / pharmacology
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Adrenal Cortex Hormones / therapeutic use*
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Adult
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Antigens, Surface / blood
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Antigens, Surface / immunology
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Base Sequence
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Biopsy
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DNA, Viral / blood
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DNA, Viral / genetics
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Female
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Hepatitis B virus / drug effects
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Hepatitis B virus / genetics
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Hepatitis B virus / physiology
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Hepatitis B, Chronic / complications*
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Hepatitis B, Chronic / pathology*
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Hepatitis B, Chronic / virology
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Histocytochemistry
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Humans
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Liver / drug effects
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Liver / pathology
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Liver / virology
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Molecular Sequence Data
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Point Mutation / genetics
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Polymerase Chain Reaction
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Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / complications*
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Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
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Sequence Analysis, DNA
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Time Factors
Substances
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Adrenal Cortex Hormones
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Antigens, Surface
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DNA, Viral