Norovirus Gastroenteritis Accompanied by Marked Elevation of Transaminases

A 56-year-old woman was admitted because of frequent watery diarrhea, vomiting, and abdominal cramps. An examination of the stool for norovirus antigen was positive, and a blood examination revealed a marked elevation of liver enzymes. Liver dysfunction, as well as symptoms related to gastroenteritis, was ameliorated solely by supportive treatment. Although liver injury concurrent with norovirus gastroenteritis is rarely documented and its pathogenesis remains unknown, clinicians should consider liver injury as one of the possible extra-intestinal manifestations of norovirus gastroenteritis.