A case of acute hepatitis E virus infection with clinical features indistinguishable from drug-induced liver injury

We experienced a case of acute hepatitis E virus (HEV) infection with clinical features indistinguishable from drug-induced liver injury. A 71-year old female was admitted to the hospital because of an elevation of serum trasnaminase levels. Kampo medicines had been administered four weeks before, and lymphocyte stimulation tests for Kampo medicines were positive. In consequence, we assumed that drug-induced reaction was the cause of her liver injury. Afterward, however, both immunoglobulin M antibodies against HEV and HEV RNA turned out to be positive. Finally, we diagnosed as acute HEV infection. The patient had no history of a travel abroad, ingestion of a wild boar, deer or goat. She had eaten a pig liver one month before, which was presumed as a source of infection.