A fatal case of severe acute exacerbation due to hepatitis B virus with YMDD motif mutation

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  • Shibata Hidetaka
    First department of internal medicine, Nagasaki University School of Medicine
  • Ichikawa Tatsuki
    First department of internal medicine, Nagasaki University School of Medicine
  • Nakao Kazuhiko
    First department of internal medicine, Nagasaki University School of Medicine
  • Motoyoshi Yasuhide
    First department of internal medicine, Nagasaki University School of Medicine
  • Kawashimo Hiroshi
    First department of internal medicine, Nagasaki University School of Medicine
  • Fukuta Mariko
    First department of internal medicine, Nagasaki University School of Medicine
  • Goto Takashi
    First department of internal medicine, Nagasaki University School of Medicine
  • Taura Naota
    First department of internal medicine, Nagasaki University School of Medicine
  • Nishimura Daisuke
    First department of internal medicine, Nagasaki University School of Medicine
  • Hamasaki Keisuke
    First department of internal medicine, Nagasaki University School of Medicine
  • Okubo Kazuaki
    Department of internal medicine, Sasebo Chuo hospital
  • Eguchi Katsumi
    First department of internal medicine, Nagasaki University School of Medicine

Bibliographic Information

Other Title
  • ＹＭＤＤ変異株による急性増悪のため死亡したＢ型肝硬変の１例
  • 症例報告 YMDD変異株による急性増悪のため死亡したB型肝硬変の1例
  • ショウレイ ホウコク YMDD ヘンイシュ ニ ヨル キュウセイ ゾウオ ノ タメ シボウ シタ Bガタ カンコウヘン ノ 1レイ

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Description

A 54-year-old woman was diagnosed as decompensated cirrhosis due to hepatitis B virus (HBV) in August 2001. Administration of Lamivudine was started in September 2001 and lead to undetectable HBV DNA level in serum in August 2002, accompanied by clinical and biochemical improvement. In January 2003, severe acute exacerbation developed, following increased HBV-DNA level. She had biochemical and virological improvement by conservative management. In January 2004, HBV DNA level again increased but ALT level remained normal. In September 2004, severe acute exacerbation developed and adefovir was readily administered. Although plasmapheresis and continuous hemodiafiltration were carried out, hepatic failure and encephalopathy worsened. She was complicated by bacterial pneumoniae and died in October 2004. Our case is thought to give an important information about timing of administration of adefovir for YMDD mutant.<br>

Journal

  • Kanzo

    Kanzo 47 (7), 329-333, 2006

    The Japan Society of Hepatology

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