Hepatitis B-Associated Symptomatic Iron Overload, with Complete Resolution after Nucleoside Analogue Treatment

Symptomatic iron overload and hyperferritinemia are rarely mentioned as complications of chronic hepatitis B infection. We report a case of a 70-year-old woman who presented with symptoms of iron overload including aches in the calves, fatigue, poor appetite, and low mood. Laboratory results showed a serum ferritin of 2449 μg/L and transferrin saturation of 74%. Her symptoms completely resolved with hepatitis B antiviral treatment. Serum ferritin and transferrin saturation also normalized. Symptomatic iron overload is a rare yet clinically important complication that can result from chronic hepatitis B infection.

A case of hepatitis B and mycobacterium leprae co-infection causing challenges in diagnosis and treatment

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. Most patients are asymptomatic when newly infected. However, some can develop acute hepatitis with symptoms that last several weeks, including yellowing of the skin and eyes, dark urine, extreme fatigue, nausea, vomiting and abdominal pain. There are several extrahepatic manifestations that are associated with chronic HBV infection, including arthralgia, weakness, nephritis, and generalized vasculitis. Leprosy is also an infectious disease caused by a bacillus, Mycobacterium leprae, which multiplies slowly. Leprosy mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. The co-infection of HBV and mycobacterium leprae can lead to various manifestations and complications. Hepatitis B co-infection worsen course of leprosy. Leprosy treatment can also lead to flare of latent HBV infection. In this case report, we discuss the challenges faced in diagnosing and treating co-infection and complication of leprosy in a patient with chronic hepatitis B infection. Keywords: leprosy; hepatitis B; leprosy reaction; vasculitis.