Four patients with hepatitis A presenting with fulminant hepatitis and acute renal failure and who underwent liver transplantation

Four patients with hepatitis A presenting with fulminant hepatitis and acute renal failure and who underwent liver transplantation Se Hoon Oh, M.D., Joon Hyoek Lee, M.D., Ji Won Hwang, M.D., Hye Young Kim, M.D., Chang Hoon Lee, M.D., Geum-Youn Gwak, M.D., Moon Seok Choi, M.D., Kwang Chul Koh, M.D., Seung Woon Paik, M.D., Byung Chul Yoo, M.D. Department of Internal Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea Hepatitis A is generally known as a mild, self-limiting disease of the liver, but in rare instances it can progress to fulminant hepatitis, which may require liver transplantation for recovery. Such cases are known to be related to old age and underlying liver disease. We report four cases of hepatitis A in which patients presented with fulminant hepatitis and acute renal failure and underwent liver transplantation. The following common features were observed in our cases: (1) occurrence in relatively old age (≥39 years old), (2) association with acute renal failure, (3) presence of hepatomegaly, and (4) microscopic features of submassive hepatic necrosis. (Korean J Hepatol 2009;15:362-369)