Hepatitis

Last updated: Saturday, 04, December, 2010
CausesAppropriate Tests

AST, ALT (with AST/ALT ratio), GGT, ALP, LD, bilirubin, albumin, protein (total); urinalysis; FBC, blood film; PT.

Liver biopsy, if indicated.

See also Hepatic failure

Acute

Infection, especially

 

 

 

 

 

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: AST, ALT, ALP, GGT, total 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

Autoimmune hepatitis 

Smooth muscle antibodies, antinuclear antibodies, mitochondrial antibodies, liver/kidney microsomal antibodies.

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

Hodgkin's disease

Berylliosis