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Increased transaminases in psychiatry: a case report
A el Nawar1, O Le Moine, E Nouar
1Department of Gastroenterology, Université Libre de Bruxelles, Hopital Erasme, Belgium.
Acta Gastro-Enterologica Belgica
|July 1, 1997
Summary
This case highlights hypoxic hepatitis in a patient with psychiatric issues. Cardiovascular evaluation is crucial for unexplained hepatitis, especially in those with heart conditions.
Area of Science:
- Cardiology
- Hepatology
- Internal Medicine
Background:
- A patient presented with psychiatric symptoms and subsequently developed severe hepatitis of unknown origin.
- The patient had a history of decompensated cardiomyopathy, with medications recently discontinued.
Observation:
- Despite no clear signs of heart failure, the patient experienced malaise preceding elevated liver enzymes.
- Diagnostic work-up included liver biopsy, pressure measurements, and negative toxicology/viral screens, suggesting hypoxic hepatitis.
- Holter monitoring revealed episodes of ventricular tachycardia.
Findings:
- Hypoxic hepatitis was diagnosed, likely secondary to cardiac dysfunction.
- Treatment with Dobutamine and antiarrhythmics rapidly improved liver function and decreased transaminase levels.
Implications:
- This case underscores the importance of considering cardiovascular causes in patients with unexplained hepatitis.
- Prompt cardiac assessment and management can be critical for improving outcomes in such cases.