Liver Transplantation in a Patient with Fulminant Hepatic Failure Associated with Leptospirosis
Keywords:
Case Report, Liver Transplant, Leptospirosis, Weil’s Disease, Fulminant HepatitisAbstract
Leptospirosis is a zoonosis that can progress to severe forms, such as Weil’s syndrome, characterized by jaundice and liver failure. This report describes the case of a 13-year-old female patient who initially presented with epigastric pain, myalgia, fever, and jaundice, later progressing to fulminant hepatitis. Serology confirmed leptospirosis with positive IgM, and the patient underwent an emergency liver transplant due to severe hepatic failure, with complications including ascites, coagulopathy, and the need for dialysis. The liver explant revealed submassive necrosis and advanced fibrosis. The favorable postoperative outcome highlights the importance of early disease recognition and a multidisciplinary approach in critical cases. This report significantly contributes to the limited literature on liver transplantation associated with leptospirosis.
Downloads
References
1. Pan American Health Organization. Leptospirosis. [access on 2 Oct 2024] Disponível em: https://www.paho.org/en/topics/leptospirosis
2. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Leptospirose: diagnóstico e manejo clínico. [access on 2 Oct 2024]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/leptospirose-diagnostico-manejo-clinico2.pdf
3. Marteli NA. Análise espacial da leptospirose no Brasil. Saúde debate, 2020; 44(126). https://doi.org/10.1590/0103-1104202012616
4. Rajapakse S. Leptospirosis: clinical aspects. Clin Med (Lond), 2022; 22(1): 14-7. https://doi.org/10.7861/clinmed.2021-0784
5. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis, 2003; 3(12): 757-71. https://doi.org/10.1016/s1473-3099(03)00830-2
6. Petakh P, Isevych V, Kamyshnyi A, Oksenych V. Weil’s disease –Immunopathogenesis, multiple organ failure, and potential role of gut microbiota. Biomolecules, 2022; 12(12): 1830. https://doi.org/10.3390/biom12121830
7. Miyahara S, Saito M, Kanemaru T, Villanueva SYZM, Gloriani NG, Yoshida S. Destruction of the hepatocyte junction by intercellular invasion of Leptospira causes jaundice in a hamster model of Weil’s disease. Int J Exp Pathol, 2014; 95(4): 271-81. https://doi.org/10.1111/iep.12085
8. Shintaku M, Itoh H, Tsutsumi Y. Weil’s disease (leptospirosis) manifesting as fulminant hepatic failure: report of an autopsy case. Pathol Res Pract, 2014; 210(12): 1134-7. https://doi.org/10.1016/j.prp.2014.08.011
9. Lebreton T, Aubrun F, Mabrut JY, Heyer L, Perrin C. Liver transplantation for acute liver failure attributed to leptospirosis: a report of two cases. Case Rep Crit Care, 2019; 2019: 1-4. https://doi.org/10.1155/2019/5189542
10. Ramachandran R, Almedia D, Lindo J, Vellappan N. Pathology and pathogenesis of human leptospirosis: a commented review. Rev Inst Med Trop Sao Paulo. 2018; 60: e23. https://doi.org/10.1590/S1678-9946201860023
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Tércio Genzini, Mariana Kobata Caio, Fernando Kruglensky Lerner, Thaís Franco Dias, Philipe Ho, Tiago Genzini de Miranda, Yasmin Ciamaricone Moukbel, Juliana Ferreira Ferranti, Juan Raphael Branez Pereira, Fernanda Ribeiro Danziere
This work is licensed under a Creative Commons Attribution 4.0 International License.
