Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2015; 21(32): 9671-9674
Published online Aug 28, 2015. doi: 10.3748/wjg.v21.i32.9671
Hepatitis A complicated with acute renal failure and high hepatocyte growth factor: A case report
Shinji Oe, Michihiko Shibata, Koichiro Miyagawa, Yuichi Honma, Masaaki Hiura, Shintaro Abe, Masaru Harada
Shinji Oe, Michihiko Shibata, Koichiro Miyagawa, Yuichi Honma, Masaaki Hiura, Shintaro Abe, Masaru Harada, Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
Author contributions: Oe S, Shibata M, Miyagawa K, Honma Y, Hiura M, Abe S and Harada M designed the report; Oe S and Shibata M wrote the paper.
Conflict-of-interest statement: All authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shinji Oe, MD, Third department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan. ooes@med.uoeh-u.ac.jp
Telephone: +81-93-6917437 Fax: +81-93-6920107
Received: December 25, 2014
Peer-review started: December 28, 2014
First decision: January 22, 2015
Revised: January 30, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: August 28, 2015
Processing time: 246 Days and 3.1 Hours
Abstract

A 58-year-old man was admitted to our hospital. Laboratory data showed severe liver injury and that the patient was positive for immunoglobulin M anti-hepatitis A virus (HAV) antibodies. He was also complicated with severe renal dysfunction and had an extremely high level of serum hepatocyte growth factor (HGF). Therefore, he was diagnosed with severe acute liver failure with acute renal failure (ARF) caused by HAV infection. Prognosis was expected to be poor because of complications by ARF and high serum HGF. However, liver and renal functions both improved rapidly without intensive treatment, and he was subsequently discharged from our hospital on the 21st hospital day. Although complication with ARF and high levels of serum HGF are both important factors predicting poor prognosis in acute liver failure patients, the present case achieved a favorable outcome. Endogenous HGF might play an important role as a regenerative effector in injured livers and kidneys.

Keywords: Acute hepatitis; Acute renal failure; Hepatitis A virus; Hepatocyte growth factor

Core tip: Renal involvement with hepatitis B and C is well described. However, the mechanism of hepatitis A-associated acute renal failure (ARF) is uncertain. Although the prognosis of hepatitis A is generally good, complication with ARF can have a negative impact. Hepatocyte growth factor (HGF) is a predictive factor for acute liver failure. Fulminant hepatic failure patients with high serum HGF have high mortality. By contrast, HGF is also an important factor accelerating tissue regeneration of injured organs, including the liver and kidneys. Here, we describe a patient with acute hepatitis A who achieved a favorable outcome despite complications with both ARF and high serum HGF.