INCREASED TRANSAMINASES IN PSYCHIATRY - A CASE-REPORT

We report the case of a patient admitted to the hospital with psychiat ric troubles. Soon after admission, he presented severe hepatitis of u nknown origin, Careful review of the charts, transvenous liver biopsy, right heart and hepatic pressure measurements, negative toxicologic a nd viral screenings were highly suggestive of hypoxic hepatitis, Indee d, the patient had previously been treated for a decompensated cardiom yopathy and medications stopped prior to the current admission, Withou t clear clinical evidence of heart failure he presented a brief malais e two days before the increase in liver enzymes, Hotter heart recordin g showed afterwards bouts of ventricular tachycardia. Treatment with D obutamine and antiarrythmics led to a rapid decrease of transaminase l evels and recovery in liver function, Unfortunately, he died three wee ks later from his cardiomyopathy. This case illustrates the need for c ardiovascular work-up in the context of hepatitis from unknown origin.