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13 October 2020: Articles

A Case of Fulminant Liver Failure in a 24-Year-Old Man with Coinfection with Hepatitis B Virus and SARS-CoV-2

Unusual clinical course

Elrazi Ali A* , Hisham Ziglam A , Samah Kohla E , Mohanad Ahmed C , Mohamed Yassin A

DOI: 10.12659/AJCR.925932

Am J Case Rep 2020; 21:e925932

Table 1. Shows the lab investigation done for the patients, including toxicology screen, liver function, hepatitis serology, and inflammatory markers.

Lab resultNormal range
Blood groupO positive
Absolute neutrophil count7.0×10/uL
Eosinophil count0.0×10/uL0–0.5
LymphocyteCount 1.7×10/uL1–3×10/uL
Hemoglobin13.9 gm/dL13–17 gm/dL
Platelets64×10/uL150–400 10/uL
Creatinine30562–106 umol/L
urea8.7 umol/L2.8–8.1 umol/L
HCO7 mmol/L22–29 mmol/L
Glucose3.2 mmol/L3.3–5.5 mmol/L
Lactate22.8 mmol/L0.5–2.2 mmol/L
ALT>7000 U/L0–41 U/L
AST>7000 U/L0–40 U/L
INR9.8Critical high >4.9
Prothrombin time84.97.9–11.8
bilirubin115 umol/L0–21 umol/L
Albumin37 gm/L35–53 gm/L
LDH1,134 U/L135–225 U/L
Ammonia268 umol/L16–60 umol/L
D-dimer11.51 mg/L FEU0–0.44 mg/L FEU
Fibrinogen0.8 gm/L2–4.1 gm/L
Cholesterol0.7 mmol/LNormal:
TAG0.7 mmol/LNormal:
Acetaminophen level193 umol/LTherapeutic Range: 66–199 umol/L
Ethanol levelCritical: >44.9 mmol/L
SalicylateTherapeutic range: 15–30 mg/dL for Anti-inflammatory/Rheumatic condition, Toxic: >30 mg/dL, Lethal: >60
CRP67.4 mg/L0–5 mg/L
Ferritin20,573.0 ug/L38–270 ug/L
Procalcitonin4.89 ng/mL>2.0 ng/mL represents a high risk of sever sepsis and/or septic shock ng/mL
Blood culuresNegative
HIV Ag/Ab comboNegative
Hepatitis C AbNegative
Hepatitis c PCRNegative
Hepatitis A total AbNegative
Hepatitis B S AgPositive
Hepatitis B S Ag AbAntibody titers of ≥10 mIU/ml post HBV vaccination confirms successful
Hepatitis B S AgPositive
Hepatitis B PCR>170,000,000 IU/mL
Hepatitis B core Ab IgMPositive
Hepatitis B e AgPositive
Hepatitis B e AbNegative
Hepatitis D AbNegative

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923