acute hepatitis

acute hepatitis

Liver inflammation of abrupt onset.
 
Aetiology
Autoimmune, drugs, idiopathic (up to 70% in some services), toxins, viral (HAV, HBV, HCV, HEV).
 
Clinical findings
Low-grade fever, anorexia, nausea, vomiting, fatigue, malaise, headache, photophobia, pharyngitis, cough; later, dark urine, light stool, jaundice, hepatomegaly, ± splenomegaly, ± lymphadenopathy.
 
Diagnosis
Liver biopsy; increased transaminases (ALT, AST); increased virus-specific IgG or IgM.

Acute hepatitis, differential diagnosis
Alcohol
Perivenular ballooning with neutrophils, Mallory bodies, steatosis, fibrosis.

Biliary disease
No lobular disease, ± granulomas, minimal cholestasis, duct proliferation, ± ductopaenia, copper-binding protein (black dots with orcein; blue with Victoria blue).

Chronic hepatitis/cirrhosis
Fibrosis vs necrosis.

Drugs
Minimal portal-tract inflammation (neutrophils, eosinophils, granulomas), bile duct damage with certain agents (paraquat, floxacillin).

Viral
• EBV—minimal liver damage, atypical lymphocytes in sinusoids, portal tracts.
• CMV/HSV—confluent necrosis, scattered lymphocytes in sinusoids, viral inclusions.

acute hepatitis

Clinical medicine Liver inflammation of abrupt onset, which may be due to a viral infection–eg HAV or toxins Clinical Low-grade fever, anorexia, N&V, fatigue, malaise, headache, photophobia, pharyngitis, cough; later, dark urine, light stool, jaundice, hepatomegaly, ± splenomegaly, ± lymphadenopathy Diagnosis Liver biopsy; ↑ transaminases–ALT, AST, ↑ virus-specific IgG or IgM Pathology Diffuse lymphocytic and plasmacytic inflammation, patchy–piecemeal necrosis, and liver cell degeneration in the form of either lytic–ballooning or coagulative–acidophilic degeneration; AH may be accompanied by a collapse of the central reticulin fibers surrounding the hepatocytes; activated Kupffer cells may be filled with phagocytic debris. Cf Chronic hepatitis.
References in periodicals archive ?
In Tuskegee, the rate of acute hepatitis C infection has more than doubled from 2007 to 2011," said Tuskegee Mayor Johnny Ford.
Acute hepatitis C virus infections more than tripled among young people in Kentucky, Tennessee, Virginia, and West Virginia between 2006 and 2012, investigators reported online May 8 in Morbidity and Mortality Weekly Report.
To the Editor: The number of sporadic autochthonous cases of acute hepatitis E is increasing in many industrialized countries (7).
Most of the patients suffering from acute hepatitis B recover spontaneously without significant consequences.
Summer season epidemics of this type of acute hepatitis are very common throughout the developing world.
Responsible for a number of conditions, ranging from mild kennel cough, through to acute hepatitis with liver failure and death, adenovirus is a pretty nasty wee chap too.
2) Of paramount importance, any bona fide new diagnosis of acute hepatitis A has public health implications.
He had presented with acute hepatitis a few years ago, and on followup at 6 months was found to be hepatitis BsAg positive and treated for 1 year with 3TC (lamivudine).
The patient was diagnosed with acute hepatitis secondary to hepatitis E virus and was treated with conservative measures in the hospital.
The spokeswoman added: "The health board was alerted to the problem when the patient who received treatment at the unit and was discharged as planned after making a good recovery was later newly diagnosed with an acute hepatitis B infection.
The majority of the patients presented clinically with chronic hepatitis, a few as cirrhosis and occasional one as acute hepatitis.
Also there was difference in transaminase concentration in acute hepatitis with age.

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