A Case of Fulminant Hepatitis Induced by Measles in an 8-Month-Old Female

Authors

  • Muhammad Mujtaba Naseer Teaching Hospital Peshawar Pakistan https://orcid.org/0000-0003-4492-6393
  • Ayesha Khan Naseer Teaching Hospital Peshawar Pakistan
  • Saman Gul Naseer Teaching Hospital Peshawar Pakistan
  • Farida Sherazi Naseer Teaching Hospital Peshawar Pakistan
  • Irum Naz Naseer Teaching Hospital Peshawar Pakistan

DOI:

https://doi.org/10.59736/IJP.23.02.935

Keywords:

Fulminant Hepatitis, Measles, Protein-Calorie Malnutrition

Abstract

Background: Measles is a common viral infection in children that is self-limiting, but the fulminant hepatitis induced by measles is a very rare case. And we present the case of fulminant hepatitis induced by measles in an 8-month-old female.

Case presentation: we have a patient of an 8-month-old female who presented to pediatric OPD with a complaint of fever for 8 days. Clinically, she was diagnosed as a case of measles with complications (pneumonia). After 2 days of admission, she developed seizures, irritable movement, bruises, and abdominal swelling. Emergency management was started for resuscitation and ultrasound abdomen, and ALT was advised on ultrasound. Minimal ascites, gall bladder edema, and hepatomegaly were reported, and LFTs were advised by the radiologist, and ALT was 1582 U/L. At that time, she was suspected of a case of fulminant hepatitis. We put her on symptomatic treatment for liver and coagulation issues. Her symptoms improved. As far as our literature search is concerned, this is the first case to be submitted for case report in Khyber Pakhtunkhwa.

 

Author Biographies

  • Muhammad Mujtaba, Naseer Teaching Hospital Peshawar Pakistan

    House Officer

  • Ayesha Khan, Naseer Teaching Hospital Peshawar Pakistan

    House Officer

  • Saman Gul, Naseer Teaching Hospital Peshawar Pakistan

    Assistant Professor pediatrics 

  • Farida Sherazi, Naseer Teaching Hospital Peshawar Pakistan

    Senior Registrar pediatrics

  • Irum Naz, Naseer Teaching Hospital Peshawar Pakistan

    Assistant Professor pediatrics

References

Berche P. History of measles. Presse Med. 2022 Sep 1;51(3):104149. doi: 10.1016/j.lpm.2022.104149.

Minta AA. Progress toward measles elimination—worldwide, 2000–2022. MMWR Morb Mortal Wkly Rep. 2023;72:1265–71. doi: 10.15585/mmwr.mm7246a3.

Misin A, Antonello RM, Di Bella S, Campisciano G, Zanotta N, Giacobbe DR, et al. Measles: an overview of a re-emerging disease in children and immunocompromised patients. Microorganisms. 2020;8(2):276. doi: 10.3390/microorganisms8020276.

De Broucker G, Ssebagereka A, Apolot RR, Aloysius M, Kiracho EE, Patenaude B, et al. The economic burden of measles in children under five in Uganda. Vaccine X. 2020 Dec 11;6:100077. doi: 10.1016/j.jvacx.2020.100077.

European Association for the Study of the Liver (EASL). EASL clinical practical guidelines on the management of acute (fulminant) liver failure. J Hepatol. 2017 May;66(5):1047–81. doi: 10.1016/j.jhep.2016.12.003.

Talat S, Khan SA, Javed N, Malik MI. Etiology, clinical presentation, and outcome of children with fulminant hepatic failure: experience from a tertiary center in Pakistan. Pak J Med Sci. 2020 Sep-Oct;36(6):1252–6. doi: 10.12669/pjms.36.6.2375.

Nacoti M, Corbella D, Fazzi F, Rapido F, Bonanomi E. Coagulopathy and transfusion therapy in pediatric liver transplantation. World J Gastroenterol. 2016 Feb 14;22(6):2005–23. doi: 10.3748/wjg.v22.i6.2005.

Lee KY, Lee HS, Hur JK, Kang JH, Lee BC. Clinical features of measles according to age in a measles epidemic. Scand J Infect Dis. 2005;37(6-7):471–5. doi: 10.1080/00365540510037803.

Giladi M, Schulman A, Kedem R, Danon YL. Measles in adults: a prospective study of 291 consecutive cases. BMJ (Clin Res Ed). 1987;295(6609):1314. doi: 10.1136/bmj.295.6609.1314.

Biron C, Beaudoux O, Ponge A, Briend-Godet V, Corne F, Tripodi D, et al. Rougeole au CHU de Nantes au cours de l'épidémie 2008-2009 [Measles in the Nantes Teaching Hospital during the 2008-2009 epidemic. Med Mal Infect. 2011 Aug;41(8):415–23. doi: 10.1016/j.medmal.2010.09.002.

Panackel C, Thomas R, Sebastian B, Mathai SK. Recent advances in management of acute liver failure. Indian J Crit Care Med. 2015 Jan;19(1):27–33. doi: 10.4103/0972-5229.148636.

Papadopoulou A, Theodoridou M, Syriopoulou V, Mostrou G, Kattamis CH. Hepatitis in children hospitalized with measles: the experience acquired after a Greek epidemic. J Paediatr Child Health. 2001 Feb;37(1):55–7. doi: 10.1046/j.1440-1754.2001.00580.x.

Gianniki M, Siahanidou T, Botsa E, Michos A. Measles epidemic in pediatric population in Greece during 2017–2018: epidemiological, clinical characteristics and outcomes. PLoS One. 2021 Jan 20;16(1):e0245512. doi: 10.1371/journal.pone.0245512.

Hashimoto K, Kashihara T, Kotani K, Fujimori E, Ohki A, Kawakami F, et al. [A case of measles associated with severe damage of the liver and kidneys]. Nihon Shokakibyo Gakkai Zasshi. 1992 Feb;89(2):548–51. Japanese. PMID: 1569710.

Nobili V, Pietro S, Petrini S. Fulminant hepatic failure following measles. Pediatr Infect Dis J. 2007 Aug;26(8):766–7. doi: 10.1097/INF.0b013e3180cc2c4f.

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Published

2025-07-02

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Section

Case Reports

How to Cite

1.
Mujtaba M, Khan A, Gul S, Sherazi F, Naz I. A Case of Fulminant Hepatitis Induced by Measles in an 8-Month-Old Female. Int J Pathol [Internet]. 2025 Jul. 2 [cited 2025 Jul. 6];23(2):105-9. Available from: https://jpathology.com/index.php/OJS/article/view/935