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Acute hepatitis of unknown origin in 38-year-old man: A case report
Petar Trifonov1, Donika Todovichin1, Cvetelina Marinova1
1Clinic of Gastroenterology, UMHAT St. Ivan Rilski, Sofia, Bulgaria.
Rationale:
Acute hepatitis of unknown origin represents a diagnostic and therapeutic challenge, particularly when common viral, autoimmune, and toxic causes of acute liver injury are excluded.
Patient Concerns:
We report a case of an adult male. He presents with general fatigue, jaundice, fever, abdominal discomfort. Laboratory findings of severe acute hepatitis and extremely elevated transaminases.
Diagnoses:
Full laboratory, serological, and toxicological tests ruled out viral, autoimmune, and drug-induced hepatitis. Metabolic disorders such as Wilson disease and hemochromatosis were also excluded.
Interventions:
Supportive therapy consisting of intravenous glucose solutions, silymarin, vitamin C, and ademetionine was initiated.
Outcomes:
The patient had rapid clinical improvement, with normalization of liver enzymes at 1-month follow-up.
Lessons:
This case shows the importance of a systematic diagnostic approach in acute hepatitis of unknown origin. It suggests that, in adult patients, conservative management with supportive therapy may lead to full recovery despite severe biochemical abnormalities.
