Therapeutic Plasma Exchange in Parvovirus B19-induced Acute Hepatic Failure

Dhirendra P Singh; Sheetal Agarwal; Ruby Singh; Devki Nandan; Anubhav Gupta

doi:10.5005/jp-journals-10071-23421

Therapeutic Plasma Exchange in Parvovirus B19-induced Acute Hepatic Failure

Indian J Crit Care Med. 2020 May;24(5):361-362. doi: 10.5005/jp-journals-10071-23421.

Authors

Dhirendra P Singh¹, Sheetal Agarwal¹, Ruby Singh¹, Devki Nandan¹, Anubhav Gupta²

Affiliations

¹ Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, Delhi, India.
² Department of Transfusion Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, Delhi, India.

Abstract

Parvovirus B19 has rarely been associated with acute liver failure (ALF), which has a high mortality. Plasma exchange that usually acts as a bridge to liver transplantation removes toxins, antibodies, cytokines, and can correct coagulopathy while maintaining a euvolemic state. Pediatric data regarding its use are scarce. We report a case of 16-year-old girl with acute liver failure in stage 4 encephalopathy with coagulopathy due to parvovirus B19 who was successfully managed with high-volume therapeutic plasma exchange (TPE). We tried to use it as a treatment modality due to nonavailability of in-hospital transplant facilities. Parvovirus B19 may be an underdiagnosed cause of acute viral hepatitis. Therapeutic plasma exchange can act as a bridge to liver transplant (LT) or bridge to recovery especially in self-limiting illnesses such as viral hepatitis.

How to cite this article: Singh DP, Agarwal S, Singh R, Nandan D, Gupta A. Therapeutic Plasma Exchange in Parvovirus B19-induced Acute Hepatic Failure. Indian J Crit Care Med 2020;24(5):361-362.

Keywords: Hepatic encephalopathy; Hepatic failure; Plasma exchange..