Open AccessTherapeutic Plasma Exchange in Parvovirus B19-induced Acute Hepatic Failure
Author(s) -
D. P. Singh,
Saurabh Agarwal,
Ruby Singh,
Devki Nandan,
Anubhav Gupta
Publication year - 2020
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.5005/jp-journals-10071-23421
Subject(s) - medicine , parvovirus , coagulopathy , hepatic encephalopathy , liver transplantation , acute hepatic failure , viral hepatitis , liver failure , intensive care medicine , immunology , transplantation , pediatrics , virus , cirrhosis
Parvovirus B19 has rarely been associated with acute liver failure (ALF), which has a high mortality. Plasma exchange that usually acts as a bridge to liver transplantation removes toxins, antibodies, cytokines, and can correct coagulopathy while maintaining a euvolemic state. Pediatric data regarding its use are scarce. We report a case of 16-year-old girl with acute liver failure in stage 4 encephalopathy with coagulopathy due to parvovirus B19 who was successfully managed with high-volume therapeutic plasma exchange (TPE). We tried to use it as a treatment modality due to nonavailability of in-hospital transplant facilities. Parvovirus B19 may be an underdiagnosed cause of acute viral hepatitis. Therapeutic plasma exchange can act as a bridge to liver transplant (LT) or bridge to recovery especially in self-limiting illnesses such as viral hepatitis.