Hepatitis B differential diagnosis: Difference between revisions
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==Differentiating Hepatitis B from other Diseases== | ==Differentiating Hepatitis B from other Diseases== | ||
Shown below is a table that summarizes the findings that differentiate hepatitis B from other conditions that cause [[fever]], [[nausea]], [[vomiting]], [[jaundice]], [[hepatomegaly]], and icteric [[sclera]].<ref name=CDC-Viral-Hepatitis>Centers for Disease Control and Prevention. Viral Hepatitis http://www.cdc.gov/hepatitis/ Accessed on October 4th, 2016</ref><ref name="pmid520102">{{cite journal| author=Cohen JA, Kaplan MM| title=The SGOT/SGPT ratio--an indicator of alcoholic liver disease. | journal=Dig Dis Sci | year= 1979 | volume= 24 | issue= 11 | pages= 835-8 | pmid=520102 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=520102 }} </ref><ref name="pmid3135226">{{cite journal| author=Williams AL, Hoofnagle JH| title=Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. | journal=Gastroenterology | year= 1988 | volume= 95 | issue= 3 | pages= 734-9 | pmid=3135226 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3135226 }} </ref><ref name=CDC>Centers for Disease Control and Prevention. Viral Hepatitis http://www.cdc.gov/hepatitis/ Accessed on October 4th, 2016</ref><ref name=WHO-Guideline-Hepatitis-c> World Health Organization, Guidelines for the screening care and treatment of persons with hepatitis C infection. (2015). http://apps.who.int/iris/bitstream/10665/111747/1/9789241548755_eng.pdf?ua=1&ua=1 Accessed on October 5th, 2016</ref><ref name=CDC-HAV> Centers for Disease Control and Prevention. MMWR. Prevention of Hepatitis A Through Active or Passive Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP) (2006). http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5507a1.htmAccessed on October 5th, 2016</ref> | Shown below is a table that summarizes the findings that differentiate hepatitis B from other conditions that cause [[fever]], [[nausea]], [[vomiting]], [[jaundice]], [[hepatomegaly]], and icteric [[sclera]].<ref name=CDC-Viral-Hepatitis>Centers for Disease Control and Prevention. Viral Hepatitis http://www.cdc.gov/hepatitis/ Accessed on October 4th, 2016</ref><ref name="pmid520102">{{cite journal| author=Cohen JA, Kaplan MM| title=The SGOT/SGPT ratio--an indicator of alcoholic liver disease. | journal=Dig Dis Sci | year= 1979 | volume= 24 | issue= 11 | pages= 835-8 | pmid=520102 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=520102 }} </ref><ref name="pmid3135226">{{cite journal| author=Williams AL, Hoofnagle JH| title=Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. | journal=Gastroenterology | year= 1988 | volume= 95 | issue= 3 | pages= 734-9 | pmid=3135226 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3135226 }} </ref><ref name=CDC>Centers for Disease Control and Prevention. Viral Hepatitis http://www.cdc.gov/hepatitis/ Accessed on October 4th, 2016</ref><ref name=WHO-Guideline-Hepatitis-c> World Health Organization, Guidelines for the screening care and treatment of persons with hepatitis C infection. (2015). http://apps.who.int/iris/bitstream/10665/111747/1/9789241548755_eng.pdf?ua=1&ua=1 Accessed on October 5th, 2016</ref><ref name=CDC-HAV> Centers for Disease Control and Prevention. MMWR. Prevention of Hepatitis A Through Active or Passive Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP) (2006). http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5507a1.htmAccessed on October 5th, 2016</ref><ref name="pmid2583685">{{cite journal| author=Buti M, Esteban R, Jardi R, Rodriguez-Frias F, Casacuberta J, Esteban JI et al.| title=Chronic delta hepatitis: detection of hepatitis delta virus antigen in serum by immunoblot and correlation with other markers of delta viral replication. | journal=Hepatology | year= 1989 | volume= 10 | issue= 6 | pages= 907-10 | pmid=2583685 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2583685 }} </ref> | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral Hepatitis A]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral Hepatitis A]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Abrupt onset of prodromal symptoms | |||
*Detectable serum immunoglobulin M (IgM) anti-HAV antibodies | |||
*[[hepatitis A|Hepatitis]], caused by the [[hepatitis A virus]], produces a self-limited disease | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral Hepatitis C]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral Hepatitis C]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Symptoms]] are similar to the ones of [[hepatitis B]], however, [[hepatitis C]] | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Acute hepatitis with possible recent exposure to HCV (needle-stick) | |||
*[[Symptoms]] are similar to the ones of [[hepatitis B]], however, [[hepatitis C]] can cause acute and/or chronic hepatitis | |||
*[[Serologic]] testing will help differentiate these two conditions | |||
*Detectable HCV RNA by [[PCR]] and anti-HCV antibody testing by [[enzyme-linked immunosorbent assa|enzyme-linked immunosorbent assay (ELISA]]) | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Viral Hepatitis D]]''' | | style="padding: 5px 5px; background: #DCDCDC;" |'''[[Viral Hepatitis D]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |[[Symptoms]] are similar to the ones of [[hepatitis B]], however, [[hepatitis D]] is a serious [[liver disease]] caused by [[infection]] with the [[Hepatitis D virus]] | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*[[Symptoms]] are similar to the ones of [[hepatitis B]], however, [[hepatitis D]] is a serious [[liver disease]] caused by [[infection]] with the [[Hepatitis D virus]] | |||
*Only occurs among people who are [[infected]] with the [[hepatitis B virus]] ([[HBV]]) | |||
*May complicate into [[cirrhosis]] and [[hepatocellular carcinoma]]. [[Serologic]] testing will help differentiate these two conditions | |||
*Detectable IgM anti-HBc with Serum HDAg (enzyme-linked (EIA) or radioimmunoassays (RIA)) | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral Hepatitis E]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[Viral Hepatitis E]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Symptoms]] are similar to the ones of [[hepatitis B]], however, [[hepatitis E]], caused by the [[hepatitis E virus]], may complicate, in rare cases, into [[chronic hepatitis]] and [[liver failure]]. [[Serologic]] testing will help differentiate these two conditions. | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*[[Symptoms]] are similar to the ones of [[hepatitis B]], however, [[hepatitis E]], caused by the [[hepatitis E virus]], may complicate, in rare cases, into [[chronic hepatitis]] and [[liver failure]]. [[Serologic]] testing will help differentiate these two conditions. | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Alcoholic Hepatitis]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[Alcoholic Hepatitis]]''' | ||
Revision as of 18:29, 10 October 2016
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Hepatitis B |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatitis B differential diagnosis On the Web |
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American Roentgen Ray Society Images of Hepatitis B differential diagnosis |
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Risk calculators and risk factors for Hepatitis B differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Hepatitis B must be differentiated from other diseases that cause fever, nausea, vomiting, jaundice, hepatomegaly, icteric sclera, elevated ALT, AST, such as other viral hepatitis, alcoholic hepatitis, and autoimmune hepatitis.[1][2][3]
Differentiating Hepatitis B from other Diseases
Shown below is a table that summarizes the findings that differentiate hepatitis B from other conditions that cause fever, nausea, vomiting, jaundice, hepatomegaly, and icteric sclera.[1][2][3][4][5][6][7]
| Disease | Findings |
|---|---|
| Viral Hepatitis A |
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| Viral Hepatitis C |
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| Viral Hepatitis D |
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| Viral Hepatitis E |
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| Alcoholic Hepatitis | Symptoms are similar to the ones of hepatitis B, however, alcoholic hepatitis is related to the excessive use of alcohol. Alcoholic hepatitis presents more often with ascites. Alcoholic hepatitis often leads to cirrhosis and liver failure, if alcohol use is not decreased. Serologic testing will help differentiate these two conditions. Also laboratory results show ALT<AST in alcoholic hepatitis (inverse from viral hepatitis, which is ALT>AST). |
| Autoimmune Hepatitis | Autoimmune hepatitis occurs when the body's immune system attacks the hepatocytes. It often affects young females and may present with signs of acute hepatitis or chronic liver disease. Serologic testing will help differentiate these two conditions. |
References
- ↑ 1.0 1.1 Centers for Disease Control and Prevention. Viral Hepatitis http://www.cdc.gov/hepatitis/ Accessed on October 4th, 2016
- ↑ 2.0 2.1 Cohen JA, Kaplan MM (1979). "The SGOT/SGPT ratio--an indicator of alcoholic liver disease". Dig Dis Sci. 24 (11): 835–8. PMID 520102.
- ↑ 3.0 3.1 Williams AL, Hoofnagle JH (1988). "Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis". Gastroenterology. 95 (3): 734–9. PMID 3135226.
- ↑ Centers for Disease Control and Prevention. Viral Hepatitis http://www.cdc.gov/hepatitis/ Accessed on October 4th, 2016
- ↑ World Health Organization, Guidelines for the screening care and treatment of persons with hepatitis C infection. (2015). http://apps.who.int/iris/bitstream/10665/111747/1/9789241548755_eng.pdf?ua=1&ua=1 Accessed on October 5th, 2016
- ↑ Centers for Disease Control and Prevention. MMWR. Prevention of Hepatitis A Through Active or Passive Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP) (2006). http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5507a1.htmAccessed on October 5th, 2016
- ↑ Buti M, Esteban R, Jardi R, Rodriguez-Frias F, Casacuberta J, Esteban JI; et al. (1989). "Chronic delta hepatitis: detection of hepatitis delta virus antigen in serum by immunoblot and correlation with other markers of delta viral replication". Hepatology. 10 (6): 907–10. PMID 2583685.