Hepatitis

Causes

Appropriate Tests

 

Aspartate aminotransferase, Alanine aminotransferase (with AST/ALT ratio), Alkaline phosphatase, Gamma glutamyltransferase, Lactate dehydrogenase, Bilirubin, Albumin, Protein, Urinalysis; Full blood count, Blood film; Prothrombin time.

Liver biopsy, if indicated.

See also Hepatic failure.

Acute

 

Infection, especially

  • Hepatitis A virus infection
  • Hepatitis B virus infection
  • Hepatitis C virus infection
  • Hepatitis D virus infection
  • Hepatitis E virus infection
  • Infectious mononucleosis
  • Cytomegalovirus infection
  • Q fever
  • Leptospirosis
  • Alcoholic hepatitis

 

 

 

 





 





See under Alcoholism.

Drugs, especially

  • Paracetamol
  • Flucloxacillin
  • Amoxycillin/Clavulanate
  • Anabolic steroids
  • Isoniazid
  • Anticonvulsants, especially
    • Valproate
  • NSAID
  • Halothane

 

Hepatic ischaemia

 

Chronic

The severity (grade) and degree of fibrosis (stage) are determined on Liver biopsy.

To monitor progress: Aspartate aminotransferase, Alanine aminotransferase, Alkaline phosphatase, Gamma glutamyltransferase, Protein, Albumin.

Elevated serum Immunoglobulins (IgG, IgA) and ß-gamma bridging on Protein electrophoresis support the diagnosis of chronic hepatitis. Immunoglobulins (G, A, M) - serum or protein electrophoresis are also useful to distinguish the various causes of chronic hepatitis.

A markedly raised IgM supports the diagnosis of primary biliary Cirrhosis.

Infection, especially

  • Hepatitis B virus infection
  • Hepatitis C virus infection
  • Hepatitis D virus infection

 

Autoimmune hepatitis

Smooth muscle Ab, Antinuclear Ab, Mitochondrial Ab, Liver/kidney microsome Ab.

Alcoholic hepatitis

See under Alcoholism.

Drugs, especially

  • Flucloxacillin
  • Amoxycillin/Clavulanate
  • Isoniazid

 

Wilson's disease

 

α1-antitrypsin deficiency

Alpha-1-antitrypsin.

Primary biliary cirrhosis

See under Cirrhosis.

Primary sclerosing cholangitis

 

Granulomatous

Diagnosis requires liver biopsy.

Idiopathic

 

Sarcoidosis

 

Drugs, especially

  • Allopurinol

 

Infection, especially

  • Q fever
  • Brucellosis
  • Tuberculosis
  • Candidiasis

 

Hodgkin lymphoma

 

Berylliosis