News from LufeeHepatitis B And C Remain Public Health Issue--Up To 5.3 Million Americans Infected(02-25-2010 10:49 PM)A recent report by the Institute of Medicine (IOM) confirmed that 3.5 to 5.3 million people (1-2 % of the U.S. population) have chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Despite efforts by federal, state and local government agencies to control and prevent these diseases, they remain a serious public health concern... Denver Woman Sentenced in Hepatitis Infection Case(02-25-2010 03:49 PM)An employee addicted to heroin swapped drug-filled syringes intended for patients with contaminated syringes. Ahead of the Bell: Anadys hepatitis C drug(02-25-2010 02:34 PM)NEW YORK (AP) -- Development-stage drug developer Anadys Pharmaceuticals Inc. said late Wednesday its developing hepatitis C drug was only slightly more effective at treating the virus than placebo in a midstage study.... Colo. hep C surgery tech gets 30 years in prison(02-25-2010 04:39 AM)DENVER (AP) -- A surgery technician who infected about three dozen people with hepatitis C after she injected herself with painkiller-filled syringes and replaced them with ones filled with saline was sentenced Wednesday to 30 years in prison.... Colo. Hep C Surgery Tech Gets 30 Years In Prison(02-25-2010 04:14 AM)A surgery technician who infected about three dozen people with hepatitis C after she injected herself with painkiller-filled syringes and replaced them with ones filled with saline was sentenced Wednesday to 30 years in prison. |
<pathology> Inflammation of the liver.
This entry appears with permission from the Dictionary of Cell and Molecular Biology
(11 Mar 2008)
| Hepatitis Classification and external resources |
|
 |
|
|---|---|
| Alcoholic hepatitis |
|
| ICD-10 |
K75.9 |
| ICD-9 | 573.3 |
| DiseasesDB | 20061 |
| MeSH | D006505 |
Hepatitis (plural hepatitides) implies injury to the liver characterized by the presence of inflammatory cells in the tissue of the organ. The name is from ancient Greek hepar (ηπαρ) or hepato- (ηπατο-), meaning liver, and suffix -itis, meaning "inflammation" (c. 1727)[1]. The condition can be self-limiting, healing on its own, or can progress to scarring of the liver. Hepatitis is Acute
Acute hepatitis
Clinically, the course of acute hepatitis varies widely from mild symptoms requiring no treatment to fulminant hepatic failure needing liver transplantation. Acute viral hepatitis is more likely to be asymptomatic in younger people. Symptomatic individuals may present after convalescent stage of 7 to 10 days, with the total illness lasting 2 to 6 weeks.[4]
Initial features are of nonspecific flu-like symptoms, common to almost all acute viral infections and may include malaise, muscle and joint aches, fever, nausea or vomiting, Diarrhea
Chronic Hepatitis
Majority of patients will remain asymptomatic or mildly symptomatic, abnormal Blood test
Findings on clinical examination are usually those of cirrhosis or are related to aetiology.
Most cases of acute hepatitis are due to viral infections:
Other viral infections can cause hepatitis (inflammation of the liver):
Ethanol
Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C.[citation needed] The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis.
A large number of drugs can cause hepatitis:[7]
The clinical course of drug-induced hepatitis is quite variable, depending on the drug and the patient's tendency to react to the drug. For example, halothane hepatitis can range from mild to fatal as can INH-induced hepatitis. Hormonal contraception can cause structural changes in the liver. Amiodarone hepatitis can be untreatable since the long half life of the drug (up to 60 days) means that there is no effective way to stop exposure to the drug. Statins can cause elevations of liver function blood tests normally without indicating an underlying hepatitis. Lastly, human variability is such that any drug can be a cause of hepatitis.
Toxins and drugs can cause hepatitis:
Some metabolic disorders cause different forms of hepatitis. Hemochromatosis (due to iron accumulation) and Wilson's disease (copper accumulation) can cause liver inflammation and necrosis.
See below for non-alcoholic steatohepatitis (NASH), effectively a consequence of metabolic syndrome.
"Obstructive jaundice" is the term used to describe jaundice due to obstruction of the bile duct (by Gall
Anomalous presentation of human leukocyte antigen (HLA) class II on the surface of hepatocytes, possibly due to genetic predisposition or acute liver infection; causes a cell-mediated immune response against the body's own liver, resulting in autoimmune hepatitis.
In severe cases of alpha 1-antitrypsin deficiency (A1AD), the accumulated protein in the endoplasmic reticulum causes liver cell damage and inflammation.
Non-alcoholic fatty liver disease (NAFLD) is the occurrence of fatty liver in people who have no history of alcohol use. It is most commonly associated with obesity (80% of all obese people have fatty liver). It is more common in women. Severe NAFLD leads to inflammation, a state referred to as non-alcoholic steatohepatitis (NASH), which on biopsy of the liver resembles alcoholic hepatitis (with fat droplets and inflammatory cells, but usually no Mallory bodies).
The diagnosis depends on medical history, physical exam, blood tests, radiological imaging and sometimes a liver biopsy. The initial evaluation to identify the presence of fatty infiltration of the liver is medical imaging, including such ultrasound, computed tomography (CT), or magnetic resonance (MRI). However, imaging cannot readily identify inflammation in the liver. Therefore, the differentiation between steatosis and NASH often requires a liver biopsy. It can also be difficult to distinguish NASH from alcoholic hepatitis when the patient has a history of alcohol consumption. Sometimes in such cases a trial of abstinence from alcohol along with follow-up blood tests and a repeated liver biopsy are required.
NASH is becoming recognized as the most important cause of liver disease second only to hepatitis C in numbers of patients going on to cirrhosis.[citation needed]
Ischemic hepatitis is caused by decreased circulation to the liver cells. Usually this is due to decreased blood pressure (or shock), leading to the equivalent term "shock liver". Patients with ischemic hepatitis are usually very ill due to the underlying cause of shock. Rarely, ischemic hepatitis can be caused by local problems with the blood vessels that supply oxygen to the liver (such as thrombosis, or clotting of the hepatic artery which partially supplies blood to liver cells). Blood testing of a person with ischemic hepatitis will show very high levels of transaminase enzymes (AST and ALT), which may exceed 1000 U/L. The elevation in these blood tests is usually transient (lasting 7 to 10 days). It is rare that liver function will be affected by ischemic hepatitis.
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