Acute hepatitis: Difference between revisions

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{{DDX RUQ}}
{{DDX RUQ}}


==Diagnosis==
==Evaluation==
*LFTs
*[[LFTs]]
**AST, ALT > 1000s
**AST, ALT > 1000s
**Elevated bilirubin
**Elevated bilirubin
**Elevated alk phophatase
**Elevated alk phosphatase
*INR
*INR
**Coagulopathy
**[[liver disease induced coagulopathy|Coagulopathy]]
*Consider acetaminophen level
*Consider acetaminophen level
*Acute hepatitis panel
*Acute [[viral hepatitis|hepatitis panel]]
**Hep A Ab IgM
**Hep A Ab IgM
**Hep B cAb IgM
**Hep B cAb IgM
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==Disposition==
==Disposition==
*Consider admission for:
Consider admission for:
#Bilirubin > 20
*Bilirubin > 20
#PT 50% above normal
*PT 50% above normal
#[[Hypoglycemia]]
*[[Hypoglycemia]]
#Hypoalbuminemia
*[[Hypoalbuminemia]]
#Any [[GI bleeding]]
*Any [[GI bleeding]]


==See Also==
==See Also==
*[[Jaundice]]
*[[Jaundice]]
*[[Viral Hepatitis]]
*[[Viral Hepatitis]]
*[[Acute hepatic failure]]


==References==
==References==

Revision as of 18:18, 4 June 2020

Background

Causes of acute hepatitis

Clinical Features

Acute Hepatitis Features

Jaundice of the skin
Pediatric jaundice with icterus of sclera.

Differential Diagnosis

RUQ Pain

Evaluation

  • LFTs
    • AST, ALT > 1000s
    • Elevated bilirubin
    • Elevated alk phosphatase
  • INR
  • Consider acetaminophen level
  • Acute hepatitis panel
    • Hep A Ab IgM
    • Hep B cAb IgM
    • Hep B sAg
    • Hep B sAb
    • Hep C Ab
Anti-hepatitis A, IgM Hepatitis B surface antigen Anti-hepatitis B core, IgM Anti-hepatitis C Interpretation
Positive Negative Negative Negative Acute hepatitis A
Negative Positive Positive Negative Acute hepatitis B
Negative Positive Negative Negative Chronic hepatitis B infection
Negative Negative Positive Negative Acute hepatitis B; quantity of hepatitis B surface antigen is too low to detect
Negative Negative Negative Positive Acute or chronic hepatitis C; additional tests are required to make the determination

Management

  • Treat underlying cause

Disposition

Consider admission for:

See Also

References

  1. Ostapowicz G, Fontana RJ, Schiodt FV, et al. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med. 2002 Dec 17; 137(12): 947-54.