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Clinical Pediatrics
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Severe Cardiomyopathy Simulating Hepatitis in Adolescence

William R. Treem

Georgetown University School of Medicine and Georgetown University Medical Center

John T. Boyle

University of Pennsylvania, School of Medicine and Children's Hospital of Philadelphia

Two adolescent patients referred for evaluation of severe "hepatitis" were found to have clinically unsuspected cardiac failure. Clinical profiles were characterized by anorexia, malaise, right upper quadrant pain, mild jaundice, initially predominantly indirect hyperbilirubinemia, profound elevations of transaminases, and prolonged prothrombin time. Left ventricular failure and low cardiac output were documented by clinical examination, echocardiography, and measurements of pulmonary capillary wedge pressure and cardiac index. Acute and chronic intrinsic liver disease was ruled out by appropriate tests. At autopsy, pathologic lesions of centrilobular necrosis characteristic of hepatic hypoxia were noted, and there was evidence of marked myocardial degeneration. These two cases emphasize the need for careful cardiac examination when evaluating acute hepatitis.

Clinical Pediatrics, Vol. 25, No. 5, 260-265 (1986)
DOI: 10.1177/000992288602500506
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S. Ozsoylu and N. Kocak
Severe Cardiomyopathy Simulating Hepatitis in Adolescence
Clinical Pediatrics, January 1, 1988; 27(1): 54 - 54.
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