2010年函館地区で発症し，09年秋札幌小流行起因"new Sapporo strain"が分離されたE型劇症肝炎の2例
作者： Koji Ogawa , Yoshiya Yamamoto , Machiko Umemura , Jong-Hon Kang , Hidekatsu Sakata
DOI: 10.2957/KANZO.53.206
关键词:
摘要: 2010年春函館地区ではE型劇症肝炎2例が同時期に発生したが，分離同定されたE型肝炎ウイルス（HEV）株（JFI-Hak10，JFS-Hak10）は何れもGenotype 4に属し，遺伝子系統解析により2009年秋に発生したE型急性肝炎札幌圏小流行で分離された"new Sapporo strain"と近縁な同一系統株であることが判明した．症例は63歳と73歳のいずれも女性で2010年3月下旬に発症し4月上旬に函館市内の2病院に入院となった．症例1は劇症肝炎急性型を呈するも速やかに改善し第22病日退院となった．しかし症例2は肝炎が遷延し劇症肝炎亜急性型を呈し第50病日死亡した．血中HEV RNAをretrospectiveに定量したところ生存例ではウイルス量が順調に減衰したが，死亡例では血中HEV RNA量の減衰を認めず，肝炎の遷延化に関連し不幸な転帰につながった可能性が考えられた．
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