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 ?
Benait VS, Sander V, Purikh F, Muragesh M, Ranka VS.Outcome of acute hepatic failure due to acute hepatitis E in pregnant women.
But what about severe acute hepatitis? Can we spare those initial 6 months watching and waiting only to eventually start therapy for chronic hepatitis?
Roche receives FDA approval for acute hepatitis B test It was no Halloween trick when, on Oct.
However, indigenous cases of acute hepatitis E recently have been reported in the United States, Europe, Japan, and New Zealand, and recent population based surveys have shown that 20% or more of American adults have serologic evidence of past HEV infection.
ATLANTA -- The incidence of acute hepatitis B is nearly twice as high among adults with diabetes as in those without, according to new data from the Centers for Disease Control and Prevention.
Patients taking buprenorphine for opioid dependence may experience acute hepatitis (SON: C, 1 case report).
A randomized controlled trial to assess the safety and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis. Phytomed 16:5;391-400.
In both studies it was observed that cases with viral hepatitis had later onset of acute hepatitis, large elevations in hepatic transaminases and a longer time for normalization of liver function as compared to DIH cases.
The recent outbreaks of acute HCV infections have enabled a more detailed description of the natural course of acute hepatitis C infection in HIV-infected individuals.
The system automatically scanned electronic medical records for seven infectious diseases--active tuberculosis, acute hepatitis A, acute hepatitis B, acute hepatitis C, chlamydia, gonorrhea and pelvic inflammatory disease--and electronically reported them to the health department.
Patients who are being followed or treated for acute hepatitis B infection should get repeated marker tests to look for hepatitis B surface antigens to appear, which would indicate that they've recovered from the infection.

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