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| 1 | Hepatitis E virus in patients with acute severe liver injury显示文摘AIM: To examine the incidence of hepatitis E(HepE) in individuals with acute liver injury severe enough to warrant treatment at a transplant unit.METHODS: Hepatitis E virus(HEV) is an emerging pathogen in developed countries causing severe illness, particularly in immunocompromised patients or those with underlying chronic liver disease. HepE infection isoften under diagnosed, as clinicians can be reluctant to test patients who have not travelled to regions traditionally considered hyperendemic for HepE. There are few data regarding the significance of HEV in patients with very severe acute liver injury in developed countries. Eighty patients with acute severe liver injury attending the Scottish Liver Transplant unit were tested for HEV and anti-HEV IgG and IgM. Severe acute liver injury was defined as a sudden deterioration in liver function confirmed by abnormal liver function tests and coagulopathy or presence of hepatic encephalopathy. Eighty percent of these patients were diagnosed with paracetomol overdose. No patients had a history of chronic or decompensated chronic liver disease at time of sampling. IgG positive samples were quantified against the World Health Organization anti-HEV IgG standard. Samples were screened for HEV viral RNA by quantitative reverse transcription polymerase chain reaction.RESULTS: Four cases of hepatitis E were identified. Three of the four cases were only diagnosed on retrospective testing and were initially erroneously ascribed to drug-induced liver injury and decompensated chronic liver disease, with the cause of the decompensation uncertain. One case was caused by HEV genotype 1 in a traveller returning from Asia, the other three were autochthonous and diagnosed on retrospective testing. In two of these cases(where RNA was detected) HEV was found to be genotype 3, the most prevalent genotype in developed countries. Three patients survived, two of whom had been misdiagnosed as having drug induced liver injury. The fourth patient died from sepsis and liver failure precipitated as a result of hepatitis E infection and previously undiagnosed cirrhosis. Histopathology data to date is limited to mainly that seen for endemic HepE. All patients, with the exception of patient 1, demonstrated characteristics of HepE infection, as seen in previously described locally acquired cases.CONCLUSION: In patients with acute severe liver injury, HEV testing should be part of the initial diagnostic investigation algorithm irrespective of suspected initial diagnosis, age or travel history. | Claire Louise Crossan Kenneth J Simpson Darren G Craig Christopher Bellamy Janice Davidson Harry R Dalton Linda Scobie | 2014 | World Journal of Hepatology2014，6，6： | 4 |
| 2 | Spatial-temporal variability of some metal concentrations in the soil of eastern England, and implications for soil monitoring 显示文摘 | Lark R M Bellamy H Rawlins B G | 2005 | Geodma2005，133，3： | 1 |
| 3 | An elastomeric material for facial prostheses: synthesis, experimental and numerical aspects 显示文摘 | Bellamy K Limbert G Waters MG | 2003 | Biomaterials2003，24，27： | 1 |
| 4 | Acute allograft glomerulopathy associated with CMV viraemia 显示文摘 | Browne G Whitworth C Bellamy C Ogilvie M M | 2001 | Nephrol Dial Transplant2001，16，4： | 1 |
| 5 | Integrated membrane treatment in Alaska显示文摘 | Lozier C J Jones G Bellamy W | 1997 | J AWWA1997，89，10： | 1 |
| 6 | Evidence for Procollagen, a Biosynthetic Precursor of Collagen显示文摘 | Bellamy G Bomstein P | 1971 | Proc Natl Acad Sci USA1971，68，6： | 1 |
| 7 | Spatio -temporal variability of some metal concentrations in the soil of eastern England, and implications for soil monitoring 显示文摘 | LARK R M BELLAMY P H RAWLINS B G | 2006 | Geoderma2006，133，： | 1 |
| 8 | Spatio-temporal variability of some metal concentrations in the soil of eastern England, and implications for soil monitoring 显示文摘 | Lark R M Bellamy P H Rawlins B G | 2006 | Geoderma2006，133，34： | 1 |
| 9 | Projection structure of VP6, the rotavirus inner capsid protein, and comparison with bluetongue VP7 显示文摘 | Hsu G G Bellamy A R Yeager M | 1997 | J Mol Biol1997，272，3： | 1 |
| 10 | Monolayers of Porphyrin Esters: Spectral Disturbances and Molecular Interactions 显示文摘 | Bergeron J A Jr Gaines G L Bellamy W D | 1967 | J Colloid InteCace Sci1967，25，1： | 1 |
| 11 | Spatio-temporal variability of some metal concentrations in the soil of eastern England, and implications for soil monitoring显示文摘 | Lark R M Bellamy P H Rawlins B G | 2006 | Geoderma2006，133，34： | 1 |
| 12 | Barriers and facilitators to the receipt of palliative care for people with dementia:the views of medical and nursing staff显示文摘 | Ryan T Gardiner C Bellamy G | | 0，，07： | 1 |
| 13 | Projection structure of VP6, the rotavirus inner eapsid protein, and comparison with bluetongue VP7显示文摘 | Hsu G G Bellamy A R Yeager M | 1997 | J Mol Biol1997，272，3： | 1 |
| 14 | An elastomeric material for facial prostheses: synthesis, experimental and numerical testing aspects 显示文摘 | Bellamy K Limbert G Waters M G | 2003 | Biomaterials2003，24，27： | 1 |
| 15 | Projection structure of VP6,the rotavirus inner capsid protein,and comparison with bluetongue VP7显示文摘 | HSU G G BELLAMY A R YEAGER M | 1997 | J Mol Biol1997，272，3： | 1 |
| 16 | Assessing treatment plant performance显示文摘 | Bellamy W D Cleasby J L Logsdon G S | 1993 | AWWA1993，85，12： | 1 |
| 17 | Understanding combat casualty care statistics显示文摘 | Holcomb J B Stansbury L G Champion H R Wade C Bellamy R F | 2006 | J Trauma2006，60，： | 1 |
| 18 | An elastomeric material for facial prostheses: synthesis, experimental and numerical testing aspects显示文摘 | Bellamy K Limbert G Waters MG | 2003 | Biomaterials2003，24，27： | 1 |
| 19 | Acute allograft glomerulopathy associated with CMV viraemia显示文摘 | Browne G Whitworth C Bellamy C | 2001 | Nephrol Dial Transplant2001，16，4： | 1 |
| 20 | Synthesis and Structural Investigation of 1',3',3'-Trimethyl-6-hydroxy-spiro (2H-1-benzopyran-2,2'-indoline),1 ',3',3'-Trimethyl-6-methacryloyloxy-spiro (2H-1-benzopyran-2,2'-indoline) and a Copolymer with Methyl Methacrylate by 1D and 2D NMR Spectroscopy显示文摘 | Moniruzzaman M Fernando G F Bellamy A J | | 0，，： | 1 |
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