Chronic Hepatitis After Hepatitis E Virus Infection in a Patient With Non-Hodgkin Lymphoma Taking Rituximab
Authors: Laurence Ollier
Journal: Annals of Internal Medicine (2009)

Letters17 March 2009Chronic Hepatitis After Hepatitis E Virus Infection in a Patient With Non-Hodgkin Lymphoma Taking RituximabLaurence Ollier, MD, Nathalie Tieulie, MD, Frédérick Sanderson, MD, Philippe Heudier, MD, Valérie Giordanengo, MD, PhD, Jean-Gabriel Fuzibet, MD, PhD, and Elisabeth Nicand, MDLaurence Ollier, MDFrom 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., Nathalie Tieulie, MDFrom 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., Frédérick Sanderson, MDFrom 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., Philippe Heudier, MDFrom 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., Valérie Giordanengo, MD, PhDFrom 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., Jean-Gabriel Fuzibet, MD, PhDFrom 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., and Elisabeth Nicand, MDFrom 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.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-6-200903170-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 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 ...References1. Purcell RH, Emerson SU. Hepatitis E: an emerging awareness of an old disease. J Hepatol. 2008;48:494-503. [PMID: 18192058] CrossrefMedlineGoogle Scholar2. Panda SK, Thakral D, Rehman S. Hepatitis E virus. Rev Med Virol. 2007;17:151-80. [PMID: 17051624] CrossrefMedlineGoogle Scholar3. Mushahwar IK. Hepatitis E virus: molecular virology, clinical features, diagnosis, transmission, epidemiology, and prevention. J Med Virol. 2008;80:646-58. [PMID: 18297720] CrossrefMedlineGoogle Scholar4. Kamar N, Selves J, Mansuy JM, Ouezzani L, Péron JM, Guitard J, et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med. 2008;358:811-7. [PMID: 18287603] CrossrefMedlineGoogle Scholar5. Gérolami R, Moal V, Colson P. Chronic hepatitis E with cirrhosis in a kidney-transplant recipient [Letter]. N Engl J Med. 2008;358:859-60. [PMID: 18287615] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: 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.Acknowledgment: The authors thank the personnel of the Laboratoire d'Anatomie-Pathologique du CHU de Nice for technical assistance and Dr. Fanny Vandebos for examination of the liver biopsy.Disclosures: None disclosed. 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