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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 | Aromatase eytochrome 17450, the enzyme resporsible for estrogen biosynthesis 显示文摘 | Simpson E R Mahendroo M S Means G D | 1994 | Endocrinol Rev1994，15，： | 1 |
| 3 | A proposed Tropical Rainfall Measuring Mission (TRMM) satellite显示文摘 | SIMPSON J ADLER R F NORTH G R | 1988 | Bull Amer Meteor Soc1988，69，3： | 1 |
| 4 | Source apportionment of visibility degradation problems in Brisbane (Australia) using the multiple linear regression techniques显示文摘 | Chun Y C Simpson R W Mctainsh G H | 1999 | J Atmospheric Environment1999，33，19： | 1 |
| 5 | Source apportionment of visibility degradation problems in Brisbane (Australia) using the multiple linear regression techniques显示文摘 | CHAN Y C SIMPSON R W MCTAINSH G H | 1999 | Atmospheric Environment1999，33，19： | 1 |
| 6 | Detection and quantification of Fusarium culmorum and Fusarium graminearum in cereals using PCR assays显示文摘 | Nicholson P Simpson D R Weston G | 1998 | Physiological and Molecular Plant Pathology1998，53，1： | 1 |
| 7 | Treatment of heavy metal effluents by crossflow microfiltration显示文摘 | Broom G P Squires R C Simpson M P J | 1994 | J Membrane Sci1994，87，： | 1 |
| 8 | Aromatase cytochrome P450, the enzyme responsible for estrogen biosynthesis显示文摘 | Simpson E R Mahendroo M S Means G D | 1994 | Endocrine Reviews1994，15，3： | 1 |
| 9 | Benefit-cost analysis of Modesto municipal urban forest显示文摘 | McPherson E G Simpson J R Peper P J | 1999 | Journal of Arboriculture1999，25，5： | 1 |
| 10 | EpichloO endophytes grow by intercalary hyphal extension in elongating grass leaves显示文摘 | Christensen M J Bennett R J Ansari H A Koga H Johnson R D Bryan G T Simpson W R Koolaard J P Nickless E M Voisey C R | 2008 | Fungal Genetics and Biology2008，45，2： | 1 |
| 11 | Source apportionment of visibility degradation problems in Brisbane (Australia) using the multiple linear regression techniques显示文摘 | Chan Y C Simpson R W Mctainsh G H | 1999 | Atmospheric Environment1999，33，： | 1 |
| 12 | Source apportionment of visibility degradation problems in Brisbane(Australia)using multiple linear regression echniques1显示文摘 | Chan Y C Simpson R W Mctainsh G H | 1999 | Atmos1 Environ11999，33，19： | 1 |
| 13 | Patients' perspectives on the role of prepared childbirth education in decision making regarding elective labor induction显示文摘 | Simpson K R Newman G Chirino O R | | 0，，03： | 1 |
| 14 | Biomass and carbon storage of the North American deciduous forest显示文摘 | Botkin D B Simpson L G Nisbet R A | 1993 | Biogeochemistry1993，20，1： | 1 |
| 15 | Automatic classification of field-collected dinoflagellates by artificial neural network显示文摘 | CULVERHOUSE P F SIMPSON R G ELLIS R | 1996 | Marine Ecology Progress Series1996，139，： | 1 |
| 16 | Enumeration of probiotic pediacocei in animal feed:interlaboratory study显示文摘 | Leuschner R G Bew J Simpson P J | 2003 | Journal of aoac international2003，86，： | 1 |
| 17 | Genetic algorithms compared to other techniques for pipe optimization显示文摘 | Simpson R A Dandy G C Laurence J M | 1994 | Journal of water resource planning and management1994，120，4： | 1 |
| 18 | Functional significance of the alternative transcript processing of the Arabidopsis floral promoter FCA显示文摘 | Macknight R Duroux M Laurie R Dijkwel P Simpson G Dean C | | 0，，04： | 1 |
| 19 | Source apportionment of visibility degradation problems in Brisbane (Australia) using the multiple linear regres- sion techniques 显示文摘 | Chan Y C Simpson R W Mctainsh G H | 1999 | Atmospheric Environment1999，33，19： | 1 |
| 20 | RNA processing and Arabidopsis flowering time control 显示文摘 | SIMPSON G G QUESADA V HENDERSON I R | 2004 | Biochem Soc Trans2004，32，4： | 1 |
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