Hepatitis

Hepatitis:  Inflammation of the liver.

Nonviral hepatitis:  inflammation of the liver usually resulting from exposure to certain toxins or drugs.  In toxic hepatitis, liver damage (diffuse fatty infiltration of liver cells and necrosis)  usually occurs within 24 to 48 hours after exposure to toxic agents.  Alcohol, anoxia, and preexisting liver disease exacerbate the toxic effects of some of these agents.  Recovery from nonviral hepatitis for most patients is good, although a few develop fulminating hepatitis or cirrhosis.

Cause:  Toxic hepatitis may result from exposure to various hepatotoxins, such as acetaminophen, carbon tetrachloride, poisonous mushrooms, or vinyl chloride.  Drug induced hepatitis may result from a hypersensitivity reaction unique to the affected patient such as, sulfonamides and, phenothiazines (cholestasis-induced hepatitis).

Symptoms:

Anorexia
nausea and vomiting
Jaundice
Dark urine
Hepatomegaly (enlarge liver)
May have abdominal pain.

With the cholestatic form, clay colored stools and pruritus may occur.

Treatment:

Effective treatment aims to remove the causative agent by lavage( the irrigation or washing out of an organ), catharsis (a cleansing or purgation), or hyperventilation, depending on the route of exposure.

For gold or arsenic :  Dimercaprol is an antidote used for toxic hepatitis cause by these but does not prevent drug induced hepatitis caused by other substances.

Corticosteroids may be ordered for patients with the drug induced type.

Thioctic acid may be prescribed to alleviate mushroom poisoning.


Viral Hepatitis

Viral Hepatitis:  The viral form of hepatitis is an acute inflammation of the liver marked by liver cell destruction, necrosis, and autolysis ( spontaneous disintegration of cells or tissues by autologous enzymes ).  There are three types of viral hepatitis:  Type A (infectious or short incubation hepatitis), Type B (serum or long incubation hepatitis), and Type C (non-A, non-B) hepatitis.  Recently a hepatitis Type D virus has been identified.  However, this defective ribonucleic acid virus only expresses itself with active hepatitis B.

Cause:  By hepatitis viruses

Symptoms:

Preicteric phase (preceding the appearance of jaundice-yellowing of the skin):  the patient may complain of fatigue, malaise, arthralgia (pain in a joint), myalgia (muscular pain), photophobia (abnormal visual intolerance to light), and headache.
The patient may also experience nausea and vomiting, fever, liver and lymph node enlargement.  His sense of taste and smell may be alter.

Icteric phase (jaundice-icterus stage)  this phase lasts 2 to 2 weeks.  The patient may experience mild weight loss, dark urine, clay colored stools, yellow sclera and skin, and continued hepatomegaly with tenderness.

Convalescent Phase  lasts 2 to 12 weeks or possibly longer.  The patient may continue to feel fatigue, have abdominal pain or tenderness, flatulence, and indigestion.

Treatment:

There is no specific treatment that exists for hepatitis.

Rest and combat anorexia by eating small meals high in calories and protein for the early stages of this disease.

Antiemetic may be prescribed for nausea and prevent vomiting.

In severe hepatitis:  Corticosteroids may be prescribed.


Understanding Types Of Hepatitis

 
Hepatitis Type A:  (infectious)

Age of incidence:  Children and young adults

Seasonal Incidence:  Fall and Winter

Transmission:  Food, water, semen, tears, stools, and possibly urine

Incubation:  15 to 45 days

Onset:   Sudden

 Serum markers: Antibody to type A hepatitis

Prognosis:  Good

Carrier state:  NO

Hepatitis Type B:  (serum)

Age incidence:  Can occur at any age

Seasonal Incidence:  Anytime

Transmission:  Serum, blood and blood products, and semen

Incubation:  40 to 180 days

Onset:  Insidious

Serum markers:  Hepatitis B surface antigen and hepatitis B antibodies

Prognosis:   Worsens with age

Carrier state:  Yes

Hepatitis Type C (non-A, non-B)

Age incidence:  Adults

Seasonal Incidence:  Anytime

Transmission:  Serum, blood and blood products, and possibly food

Incubation:  15 to 160 days

Onset:  Insidious

Serum markers:  -

Prognosis:   Moderate

Carrier state:   Unknown

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