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.

单词	acute hepatitis
释义	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.
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