PDF(Pubmed)
Abstract：
Acute liver failure is an uncommon presentation in the clinic. Common causes for acute liver failure include viral hepatitis and drug-related hepatotoxicity. However, acute liver failure due to Budd-Chiari syndrome is rare. This case highlights the importance of necessary constrast-enhanced imaging studies to rule out vascular etiologies of acute liver failure, in addition to common causes like viral or drug-induced hepatic failure. We present a case of a male Chinese patient who presented with nausea, vomiting, fatigue, and fever after eating a large amount of fatty food. Six days after hospitalization, the patient developed acute liver failure and hepatic encephalopathy. Contrast-enhanced computerized tomography and ultrasound examinations revealed thromboses in the hepatic veins and inferior vena cava. Further testing also showed decreased protein C activity. Therefore, a diagnosis of Budd-Chiari syndrome secondary to protein C deficiency was made. He received supportive care and a transjugular intrahepatic portal shunt. Hepatic function, coagulation panel results, and clinical presentations gradually returned to normal. Budd-Chiari syndrome from protein C deficiency could be a rare but valid cause of acute liver failure in Chinese patients.
摘要：
急性肝衰竭在临床上并不常见。急性肝衰竭的常见原因包括病毒性肝炎和药物相关的肝毒性。然而,Budd-Chiari综合征引起的急性肝功能衰竭很少见。该病例强调了必要的对比增强成像研究的重要性，以排除急性肝衰竭的血管病因。除了常见的原因，如病毒或药物引起的肝功能衰竭。我们介绍了一例中国男性患者出现恶心，呕吐,疲劳,吃了大量高脂肪食物后发烧。住院六天后,患者出现急性肝衰竭和肝性脑病。对比增强计算机断层扫描和超声检查显示肝静脉和下腔静脉血栓形成。进一步的测试也显示蛋白C活性降低。因此,诊断为蛋白C缺乏症继发的Budd-Chiari综合征.他接受了支持性护理和经颈静脉肝内门静脉分流术。肝功能,凝血面板结果，临床表现逐渐恢复正常。蛋白C缺乏引起的Budd-Chiari综合征可能是中国患者急性肝衰竭的罕见但有效的原因。
