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Abstract
The main causes of liver cirrhosis include infections with the hepatitis B or C virus and chronic alcohol consumption. We present the case of a 31-year-old patient with history of alcohol consumption, with recently installed jaundice, who presented for a diagnostic workup. He is diagnosed with parenchymal and vascular decompensated liver cirrhosis. He is Child class B with two putative liver insults: chronic infection with hepatitis B virus (HBV) and chronic alcohol consumption. Given the advanced stage of cirrhosis, his history of moderate alcohol consumption and very low value of HBV viremia, in the absence of VHD coinfection, the suspicion of coexistent liver disease arose. In such situations, young individuals should be considered for coexisting autoimmune or genetic diseases. Following complete biological workup, a high value of urinary copper was found, which led to the suspicion of Wilson's disease; this was later confirmed.
Keywords: liver cirrhosis, hepatitis B virus, Wilson's disease
Rezumat
Principalele cauze de cirozä hepaticä includ inféctale cu virusurile hepatice B sau C si consumul cronic de alcool. Prezentâm cazul unui pacient in vârstà de 31 de ani, consumator cronic de alcool, care se prezintâ pentru investigarea unui sindrom icteric recent instalat. Se pune diagnosticul de cirozä hepaticä decompensatä parenchimatos si vascular, clasa Child B, pentru care se deceleazâ douà agresiuni hepatice: infectia cronicä cu virus hepatitic B (VHB) si consumul cronic de alcool. Având in vedere stadiul avansat al cirozei hepatice, consumul moderat de alcool si valoarea foarte micà a viremiei VHB, in absenta infectiei cu VHD, s-a ridicatsuspiciunea unei boli hepatice coexistente, în cazul tinerilor trebuie luate in considerare într-o astfel de situatie si bolile genetice sau cele autoimune. în urma completârii bilantului biologie se pune in evidentà o vahare foarte mare a cuprului urinar si se suspecteazà boala Wilson, care a fost ulterior confirmatà.
Cuvinte-cheie: cirozä hepaticä, virus hepatitic B, boalà Wilson
Decompensated liver cirrhosis in a young individual - differential diagnosis difficulty
Introducere
In regiunea europeanà, în anul 2012 s-au raportat 15.104 cazuri noi de infectie cu virusul hepatic B (VHB), dintre care 2.798 de cazuri (18,6%) de infectie acutä cu VHB si 12.306 (81,4%) cazuri cu infectie cronicä cu VHB. în ceea ce priveste atât infectia acutä, cât si cea cronicä, majoritatea cazurilor s-au înregistrat la...