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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2024; 14(02): 052-055
DOI: 10.1055/s-0045-1805084
Brief Report

Parvovirus B19 Infection Mimicking Autoimmune Hepatitis: A Brief Report

Kartikeya Mathur
1   Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
,
Satyam Kumar Singh
1   Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
,
Prawin Kumar
2   Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
,
Jagdish Goyal
2   Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
,
Divya Agarwal
3   Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
,
Chhagan Lal Birda
1   Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
,
Ashish Agarwal 
1   Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
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Funding None.
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Abstract

Background Parvovirus B19 can cause a variety of manifestations, mainly in children but occasionally in adults. Parvovirus hepatitis is an uncommon manifestation and is usually mild and self-limited. Parvovirus-related acute severe hepatitis and fulminant hepatitis, including acute liver failure, are rare presentations and can mimic other common causes of hepatitis. We hereby report a case of parvovirus-related severe hepatitis in adolescent girls.

Case Report A 17-year-old girl presented with fever and upper respiratory symptoms, followed by onset of jaundice. Her general and systemic physical examinations were unremarkable except for pallor and icterus. On evaluation, she had severe anemia and hepatocellular pattern of jaundice (the maximum value of total bilirubin was 53, and aspartate and alanine transaminase were 756 and 256, respectively). The etiological workup revealed negative markers for typical viral hepatitis. Still, the autoimmune profile revealed a positive antinuclear antibody, and her liver biopsy was also consistent with autoimmune hepatitis. Because of severe anemia and the absence of other hepatic decompensation, systemic viral illness with hepatic involvement was considered, and workup in the same line revealed parvovirus serology positivity. A final diagnosis of parvovirus-related acute severe hepatitis with aplastic crisis was considered, and she was managed with a short course of oral steroids. She responded well to treatment; clinical and biochemical parameters showed improvement on subsequent follow-up. Even after a prolonged follow-up of 1.5 years, she is in clinical and biochemical remission, further confirming the diagnosis of parvovirus-related acute hepatitis.

Conclusion Parvovirus can cause severe hepatitis and should be considered in the differential diagnosis of hepatitis of unknown etiology, especially if there is concomitant hematological involvement.

Keywords

acute severe hepatitis - parvovirus hepatitis - autoimmune hepatitis - case report

Guarantor of Article

Dr. Chhagan Lal Birda.


Consent

An informed consent was obtained for the publication.


Permission to Reproduce Material from Other Sources

Not required.


Ethical Approval and Informed Consent

Ethical approval was obtained from the institutional Ethics Boards. A written informed consent was obtained from the patient.


Authors' contributions

C.L.B., A.A., D.A., P.K., and J.G. contributed to the conception and design of the study. K.M., S.K.S., and C.L.B. were responsible for the generation, collection, assembly, analysis, and interpretation of data. The manuscript was drafted or revised by C.L.B., A.A., D.A., P.K., and J.G., while C.L.B. and A.A. conducted a critical revision for important intellectual content. All authors approved the final version of the manuscript.




Publikationsverlauf

Eingereicht: 17. Oktober 2024

Angenommen: 02. Februar 2025

Artikel online veröffentlicht:
24. März 2025

© 2025. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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