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| 1 | Hepatitis E virus in patients with acute severe liver injury显示文摘AIM: To examine the incidence of hepatitis E(HepE) in individuals with acute liver injury severe enough to warrant treatment at a transplant unit.METHODS: Hepatitis E virus(HEV) is an emerging pathogen in developed countries causing severe illness, particularly in immunocompromised patients or those with underlying chronic liver disease. HepE infection isoften under diagnosed, as clinicians can be reluctant to test patients who have not travelled to regions traditionally considered hyperendemic for HepE. There are few data regarding the significance of HEV in patients with very severe acute liver injury in developed countries. Eighty patients with acute severe liver injury attending the Scottish Liver Transplant unit were tested for HEV and anti-HEV IgG and IgM. Severe acute liver injury was defined as a sudden deterioration in liver function confirmed by abnormal liver function tests and coagulopathy or presence of hepatic encephalopathy. Eighty percent of these patients were diagnosed with paracetomol overdose. No patients had a history of chronic or decompensated chronic liver disease at time of sampling. IgG positive samples were quantified against the World Health Organization anti-HEV IgG standard. Samples were screened for HEV viral RNA by quantitative reverse transcription polymerase chain reaction.RESULTS: Four cases of hepatitis E were identified. Three of the four cases were only diagnosed on retrospective testing and were initially erroneously ascribed to drug-induced liver injury and decompensated chronic liver disease, with the cause of the decompensation uncertain. One case was caused by HEV genotype 1 in a traveller returning from Asia, the other three were autochthonous and diagnosed on retrospective testing. In two of these cases(where RNA was detected) HEV was found to be genotype 3, the most prevalent genotype in developed countries. Three patients survived, two of whom had been misdiagnosed as having drug induced liver injury. The fourth patient died from sepsis and liver failure precipitated as a result of hepatitis E infection and previously undiagnosed cirrhosis. Histopathology data to date is limited to mainly that seen for endemic HepE. All patients, with the exception of patient 1, demonstrated characteristics of HepE infection, as seen in previously described locally acquired cases.CONCLUSION: In patients with acute severe liver injury, HEV testing should be part of the initial diagnostic investigation algorithm irrespective of suspected initial diagnosis, age or travel history. | Claire Louise Crossan Kenneth J Simpson Darren G Craig Christopher Bellamy Janice Davidson Harry R Dalton Linda Scobie | 2014 | World Journal of Hepatology2014，6，6： | 4 |
| 2 | Expression of vascular endothelial growth factor and its receptor in hematopoietic malignancies显示文摘 | Bellamy WT Righter L Frutiger Y | 1999 | Cancer Res1999，59，2： | 1 |
| 3 | Expression of vascular endothelial derived growth factor and its receptors in hematopoietic malignancies显示文摘 | Ritcher L Frutiger Y | 1999 | Ncer Res1999，9，： | 1 |
| 4 | Identification of the bactericidal domain of lactoferrin 显示文摘 | Bellamy W Takase M Yamauehi K | 1992 | Biochimica et biophysica acta1992，1121，： | 1 |
| 5 | Susceptibility to mycobacterial infections: the importance of host genetics显示文摘 | Bellamy R | 2003 | Genes Immun2003，4，1： | 1 |
| 6 | Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis 显示文摘 | Bellamy L Casas JP Hingoran AD | 2009 | Lancet2009，373，9677： | 1 |
| 7 | Spatial-temporal variability of some metal concentrations in the soil of eastern England, and implications for soil monitoring 显示文摘 | Lark R M Bellamy H Rawlins B G | 2005 | Geodma2005，133，3： | 1 |
| 8 | An elastomeric material for facial prostheses: synthesis, experimental and numerical aspects 显示文摘 | Bellamy K Limbert G Waters MG | 2003 | Biomaterials2003，24，27： | 1 |
| 9 | Expression of vascular endothelial growth factor and its receptors in hematopoietic malignancies 显示文摘 | Bellamy WT Richter L Frutiger Y | 1999 | Cancer Res1999，59，3： | 1 |
| 10 | Rotavirus nonstructural glycoproein NSP4 alters plasma membrane permeability in mammalian cells显示文摘 | Newton K Meyer TC Bellamy AR | 1997 | J Virol1997，71，12： | 1 |
| 11 | Hyperhomocysteinemia after an oral methionine load acutely impairs endothelial function in healthy adults 显示文摘 | Bellamy MF McDowell IF Ramsey MW | 1998 | Circulation1998，98，： | 1 |
| 12 | Resuscitation from Severe hemorrhage显示文摘 | William C.Shoemaker Andrew B.Peitzman Ronald Bellamy | | 0，，2： | 1 |
| 13 | Immediate IL-10 expression following major orthopaedic trauma: relationship to anti-inflammatory response and subsequent development of sepsis显示文摘 | P. V. Giannoudis R. M. Smith S. L. Perry A. J. Windsor R. A. Dickson M. C. Bellamy | 2000 | Intensive Care Medicine2000，，8： | 1 |
| 14 | Potent antibacterial peptides generated by pepsin digestion of bovine lactoferrin显示文摘 | Tomita M Bellamy W Takase M | 1991 | J Dairy Sci1991，74，： | 1 |
| 15 | Nickel-titanium shape memory alloy Memokath 051 ureteral stent for managing long-term ureteral obstruction:4-year experience显示文摘 | Kulkarni R Bellamy E | 2001 | J Urol2001，166，5： | 1 |
| 16 | Incompleteness of market driven by a mixed diffusion显示文摘 | Bellamy N Jeanblanc M | 2000 | Finance Stochastics2000，4，： | 1 |
| 17 | Genetic susceptibility to tuberculosis显示文摘 | Bellamy R | 2005 | Clin Chest Med2005，26，2： | 1 |
| 18 | Expression of VEGF and its receptor in hematopoietic malignancies显示文摘 | Bellamy WT Richter L Frutiger Y | 1999 | Cancer Res1999，59，3： | 1 |
| 19 | Membrane destabilizing activity of rotavirus NSP4 is mediated by a membrane-proximal amphipathic domain显示文摘 | Browne EP Bellamy AR Taylor JA | 2000 | J Gen Virol2000，81，8： | 1 |
| 20 | Vascular endothelial cell growth factor is an autocrine promoter of abnormal localized immature myeloid precursors and leukemia progenitor formation in myelodysplastic syndromes显示文摘 | Bellamy WT Richter L Sirjani D | 2001 | Blood2001，97，5： | 1 |
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