{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:07:58Z","timestamp":1782137278962,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T00:00:00Z","timestamp":1547769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>The high mortality rate due to severe Herpes simplex viral (HSV) hepatitis is associated with the difficulty of its diagnosis. We describe the extremely rapid disease course of a patient who died of severe HSV hepatitis.<\/jats:p><jats:p>A 73\u2010year\u2010old woman was admitted for a bronchial asthma attack. Her symptoms improved with steroid treatment, but she developed a sore throat and painful swallowing. On day 12 after admission, she suddenly went into shock. Blood test results showed a significant increase in the liver enzyme levels, with remarkable disseminated intravascular coagulation. She died the same day.<\/jats:p><jats:p>The autopsy revealed extensive coagulative necrosis of the liver. Viral inclusion of type A Cowdry bodies was found in the residual hepatocytes in the hepatic lobule. Immunostaining revealed HSV type 1 positivity. We diagnosed the cause of death as severe HSV hepatitis. On examination of a stored serum sample, the patient tested positive for the HSV immunoglobulin (Ig)\u2010M antibody, and the HSV RNA level was very high (1\u2009\u00d7\u200910<jats:sup>9<\/jats:sup> copies\/mL). Remarkably, the HSV IgG test result was negative, and we diagnosed her as having had an initial HSV infection.<\/jats:p><jats:p>Hepatitis due to HSV is very rare in healthy adults; however, there are many reports of immune\u2010deficient cases. The presence of HSV IgG is decreasing in the elderly population because of the change in living environments\/lifestyles. The increasing use of immunosuppressive drugs, such as steroids, for treating diseases in elderly patients could be linked to the increased prevalence of initial HSV infections, resulting in liver injury.<\/jats:p>","DOI":"10.1111\/hepr.13301","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T20:24:50Z","timestamp":1545423890000},"page":"830-835","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Acute liver failure due to severe Herpes simplex viral hepatitis in an elderly woman: A case of initial infection"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9608-0444","authenticated-orcid":false,"given":"Tsuyoshi","family":"Suda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kanazawa Hospital  Kanazawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Hodo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kanazawa Hospital  Kanazawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Shirota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kanazawa Hospital  Kanazawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saiseikai Kanazawa Hospital  Kanazawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuaki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Pathology II Kanazawa Medical University  Uchinada\u2010machi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tokio","family":"Wakabayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kanazawa Hospital  Kanazawa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,18]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"38S","article-title":"Fatal herpetic hepatitis in pregnancy","volume":"62","author":"Wertheim RA","year":"1983","journal-title":"Obstet Gynecol"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.22.1.60"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.04084.x"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21250"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/85.6.694"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006565-199406000-00010"},{"key":"e_1_2_4_8_1","first-page":"125","volume-title":"Systemic Pathology. 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