A case of hepatitis E virus infection in a patient with primary biliary cholangitis

Abstract

We report an acute hepatitis E complicated with primary biliary cholangitis (PBC). A 55-year-old male who had been histologically diagnosed PBC and had treated with ursodeoxycole acid and bezafibrate, was admitted to our institute due to jaundice and liver damage. Since he had liver damage with atypical lymphocytosis in examination of blood, we considered acute viral hepatitis had occurred with PBC. Liver biopsy revealed massive infiltration of neutrophils, but the cause of the acute hepatitis was not identified. We followed with supportive measures, his liver function improved immediately, and discharged the 13th day after administrarion. It was revealed that he was positive for IgM and IgA antibodies against HEV as well as for HEV RNA of genotype 3b. Although acute hepatitis E is increasing in japan, there is no case which occurred with PBC. Therefore this case was considered quite unique.