SEVERE ACUTE CHOLESTATIC HEPATITIS-E IN A NONPREGNANT WOMAN

History and clinical findings: During a journey in Germany a 25-year-o ld French woman, who had been living in India for 6 months, developed a severe acute hepatitis with marked jaundice and transitory liver fai lure. Investigations: Serum titres for anti-hepatitis E virus immunogl obulins G and M were markedly raised during hospitalisation, proving a cute hepatitis E, a rare disease in Central Europe. Treatment and cour se: Within two weeks symptomatic treatment brought about almost comple te regression of the initially greatly increased parameters of abnorma l liver function (GPT 2277 U/I, GOT 1497 U/I, GLDH 39.2 U/I); reductio n of the total bilirubin level from initially 11.7 to 1.0 mg/dl). Indi cators of decreased liver synthesis, such as antithrombin III, partial thromboplastin time and coagulation factors II, V and VII, quickly be came normal. Flue-like and gastrointestinal symptoms and arthralgia, i mproved within a few days. Conclusion: This case documents the sporadi c occurrence in Germany and the course of severe acute hepatitis E, as sociated with marked liver damage. It demonstrates that the disease ca n take a fulminant course even in non-pregnant women, leading to sever e impairment of liver function and the danger of hepatic coma.