대한한의학회지 (The Journal of Korean Medicine)

  • 제41권4호
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  • Pages.106-111
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  • 2020
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  • 1010-0695(pISSN)
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  • 2288-3339(eISSN)
대한한의학회 (The Society of Korean Medicine)
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KM-based Treatment of Viral Hepatitis A accompanied with Pancreatitis: A case report

  • Son, Chang-Gue (Liver and Immunology Research Center, Oriental Medical College in Daejeon University)
  • 투고 : 2020.02.11
  • 심사 : 2020.11.18
  • 발행 : 2020.12.01
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초록

Objectives: Hepatitis A is a typical acute hepatitis caused by hepatovirus, and then most patients recover easily without progression to chronic condition. However, certain cases have the risk of severe symptoms or even death. This case report presented a hepatitis A accompanied with pancreatitis, which had been completely recovered in a Korean medicine hospital. Case presentation: A 38-year woman had felt the malaise, mild chilling, muscle pain and abdominal discomfort for 10 days, which led her visit doctors and took anti-pyretic analgesics and digestants. The symptoms, especially epigastric pain and fatigue, became worse, and then she hospitalized in a Korean medicine hospital. Based on the drastic elevations of hepatic enzymes (aspartate transaminase 1,604 IU/L and alanine transaminase 2,825IU/L) with an anti-HAV IgM positive, she was diagnosed with hepatitis A. After bed rest and herbal drug treatment (CGX and Innae-Tang) for 5 days, the laboratory abnormalities and subjective symptoms had been improved gradually, except the upper gastric discomfort and pain. Those symptoms had anticipated the comorbidity with HAV-induced pancreatitis, supported by the high level of serum lipase release. Another 5-day hospitalized treatment improved all subjective symptoms and then the laboratory results were completely normalized including detection of anti-HAV IgG within 15 days after discharge. Conclusion: This study presented a typical hepatitis A accompanied with pancreatitis, which should be considered in diagnosis and management of hepatitis A.

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참고문헌

  1. Chung GE, Yim JY, Kim D, Lim SH, Park MJ, Kim YS, et al. Seroprevalence of hepatitis a and associated socioeconomic factors in young healthy korean adults. Gut Liver. 2011;5(1):88-92. https://doi.org/10.5009/gnl.2011.5.1.88
  2. Jacobsen KH, Koopman JS. Declining hepatitis A seroprevalence: a global review and analysis. Epidemiol Infect. 2004;132(6):1005-22. https://doi.org/10.1017/S0950268804002857
  3. Seo JY, Seo JH, Kim MH, Ki M, Park HS, Choi BY.Pattern of hepatitis A incidence according to area characteristics using national health insurance data.J Prev Med Public Health. 2012;45(3):164-73. https://doi.org/10.3961/jpmph.2012.45.3.164
  4. Kang SH, Kim MY, Baik SK. Perspectives on Acute Hepatitis A Control in Korea. J Korean Med Sci. 2019;34(36):e230. https://doi.org/10.3346/jkms.2019.34.e230
  5. Lee H1, Cho HK, Kim JH, Kim KH. Seroepidemiology of hepatitis A in Korea: changes over the past 30 years.J Korean Med Sci. 2011;26(6):791-6. https://doi.org/10.3346/jkms.2011.26.6.791
  6. Zamir C, Rishpon S, Zamir D, Leventhal A, Rimon N, Ben-Porath E. Control of a community-wide outbreak of hepatitis A by mass vaccination with inactivated hepatitis A vaccine. Eur J Clin Microbiol Infect Dis 2001;20:185-7.
  7. Willner IR, Uhl MD, Howard SC, Williams EQ, Riely CA, Waters B. Serious hepatitis A: ananalysis of patients hospitalized during anurban epidemic in the United States. Ann Intern Med. 1998;128:111-4. https://doi.org/10.7326/0003-4819-128-2-199801150-00006
  8. Krugman S, Giles JP. Viral hepatitis.New light on an old disease. JAMA. 1970;212:1019-29. https://doi.org/10.1001/jama.1970.03170190035005
  9. Jain P, Nijhawan S, Rai RR, Nepalia S, Mathur A. Acute pancreatitis in acute viral hepatitis.World J Gastroenterol. 2007;13(43):5741-4. https://doi.org/10.3748/wjg.v13.i43.5741
  10. WHO, available at https://www.who.int/news-room/fact-sheets/detail/hepatitis-a.
  11. Yaghi C, Honein K, Boujaoude J, Slim R, Moucari R, Sayegh R. Influence of acetaminophen at therapeutic doses on surrogate markers of severity of acute viral hepatitis.Gastroenterol Clin Biol. 2006;30(5):763-8. https://doi.org/10.1016/S0399-8320(06)73311-5
  12. Matheny SC, Kingery JE. Hepatitis A. Am Fam Physician. 2012;86(11):1027-34; quiz 1010-2.
  13. Haffar S, Bazerbachi F, Prokop L, Watt KD, Murad MH, Chari ST. Frequency and prognosis of acute pancreatitis associated with fulminant or non-fulminant acute hepatitis A: A systematic review. Pancreatology. 2017;17(2):166-75. https://doi.org/10.1016/j.pan.2017.02.008
  14. Ertekin V, Selimoglu MA, Konak M, Orbak Z. Association of hepatitis a and acute pancreatitis presenting as acute abdomen. Pancreas. 2005;31(3):298-9. https://doi.org/10.1097/01.mpa.0000180904.28365.58
  15. Basaranoglu M, Balci NC, Klor HU. Gallbladder sludge and acute pancreatitis induced by acute hepatitis A. Pancreatology. 2006;6(1-2):141-4. https://doi.org/10.1159/000090255
  16. Wunschmann S, Becker B, Vallbracht A. Hepatitis A virus suppresses monocyte-to-macrophage maturation in vitro. J Virol. 2002;76(9):4350-6. https://doi.org/10.1128/JVI.76.9.4350-4356.2002
  17. GliksonM, GalunE, OrenR, Tur-KaspaR, ShouvalD. Relapsing hepatitis A. Review of 14 cases and literature survey. Medicine. 1992;71:14-23. https://doi.org/10.1097/00005792-199201000-00002
  18. Cooksley WG. What did we learn from the Shanghai hepatitis A epidemic? J Viral Hepat 2000;7:1-3. https://doi.org/10.1046/j.1365-2893.2000.00021.x
  19. Hu XP, Shin JW, Wang JH, Cho JH, Son JY, Cho CK, et al. Antioxidative and hepatoprotective effect of CGX, an herbal medicine, against toxic acute injury in mice. J Ethnopharmacol. 2008;120(1):51-5. https://doi.org/10.1016/j.jep.2008.07.042
  20. Kwak KG, Wang JH, Shin JW, Lee DS, Son CG. A traditional formula, Chunggan extract, attenuates thioacetamide-induced hepatofibrosis via GSH system in rats. Hum ExpToxicol. 2011;30(9):1322-32. https://doi.org/10.1177/0960327110389502