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Chronic Hepatitis After Hepatitis E Virus Infection in a Patient With Non-Hodgkin Lymphoma Taking Rituximab
- Laurence Ollier, MD;
- Nathalie Tieulie, MD;
- Frédérick Sanderson, MD;
- Philippe Heudier, MD;
- Valérie Giordanengo, MD, PhD;
- Jean-Gabriel Fuzibet, MD, PhD; and
- Elisabeth Nicand, MD
- From Centre Hospitalo-Universitaire de Nice, Hôpital de l'Archet, 06202 Nice Cedex 3, France, and Centre National de Référence Virus de l'Hépatite E, Hôpital d'Instruction des Armées du Val-de-Grâce, 75230 Paris Cedex 5, France.
Background: Hepatitis E virus (HEV) is endemic in developing countries, and infection typically causes acute hepatitis.
Objective: To report a case of chronic hepatitis after HEV infection in a man receiving rituximab for non-Hodgkin lymphoma.
Case Report: In August 2007, a 77-year-old man with low-grade non-Hodgkin lymphoma presented with jaundice after a few days of gastrointestinal pain. He had been receiving bimonthly rituximab for 1 year after several years of treatment with sequential chlorambucil and fludarabine. Laboratory tests showed increased levels of alanine aminotransferase and aspartate aminotransferase (more than 30-fold), γ-glutamyltransferase, bilirubin, and alkaline phosphatase. Abdominal ultrasonography excluded biliary tract complications and showed normal liver parenchyma. Test results for hepatitis B and C virus infection were negative, and hepatitis A, cytomegalovirus, and Epstein–Barr virus serologies were in accordance with past immunization. The patient's history excluded toxic and drug-related causes of elevated liver enzyme levels, and testing for other infectious …
This 100-word excerpt has been provided in the absence of an abstract.
