acute lobular hepatitis

acute lobular hepatitis

Liver inflammation of abrupt onset, which is characterised by patchy confluent pan- and multi-acinar necrosis, with loss of hepatocytes and marked ductular reaction around portal tracts. Acute lobular hepatitis with lesser degrees of necrosis and some regeneration forms nodules and mimics cirrhosis.

Clinical findings
Low-grade fever, anorexia, nausea, vomiting, fatigue, malaise, headache, photophobia, pharyngitis, cough; later, dark urine, light stool, jaundice, hepatomegaly, ±splenomegaly, ±lymphadenopathy.

Aetiology
Autoimmune, drugs, toxins, viral.
 
Lab
Decreased ALT falsely suggests liver improvement; raised prothrombin signals liver failure and need for tertiary (liver centre) referral.

Diagnosis
Liver biopsy; increased transaminases (ALT, AST); increased virus-specific IgG or IgM.
References in periodicals archive ?
A liver biopsy performed on June 1 showed severe acute lobular hepatitis with necrosis and cholestasis.

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