An Unusual Cause of Ascites in a Patient With Hepatitis B

Question: A 44-year-old man with hepatitis B presented with ascites, progressive fatigue, bilateral lower extremity weakness, and limb numbness for more than 6 months. He reported having been positive for hepatitis B surface antigen (HbsAg) for more than 20 years. Six years previously, he had presented with poor appetite and abnormal liver function, such that he was diagnosed with hepatitis B virus (HBV) infection and Lamivudine (100 mg per tablet) was initiated as an oral antiviral therapy. After treatment, no abnormal liver function results were observed, and HBV DNA levels were undetectable.