Hepatitis D 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]; Jolanta Marszalek, M.D. [3]
Overview
Hepatitis D must be differentiated from other diseases that cause fever, nausea, vomiting, jaundice, hepatomegaly, icteric sclera, and elevated ALT and AST such as viral hepatitis (caused by other etiologic agents), alcoholic hepatitis, and autoimmune hepatitis.
Differential Diagnosis
Shown below is a table that summarizes the findings that differentiate hepatitis D from other conditions that cause fever, nausea, vomiting, jaundice, hepatomegaly, and icteric sclera.[1][2]
| Disease | Findings |
|---|---|
| Viral Hepatitis A | Symptoms are similar to the ones of hepatitis D, however, hepatitis A, caused by the hepatitis A virus, produces a self-limited disease, rarely causing complications. |
| Viral Hepatitis B | Symptoms are similar to the ones of hepatitis D, however, hepatitis B is a life-threatening condition caused by the hepatitis B virus, that may lead to the development of cirrhosis and liver cancer. Serologic testing will help differentiate these two conditions. |
| Viral Hepatitis C | Symptoms are similar to the ones of hepatitis D, however, hepatitis C, caused by the hepatitis C virus, can cause acute and/or chronic hepatitis. Serologic testing will help differentiate these two conditions. |
| Viral Hepatitis E | Symptoms are similar to the ones of hepatitis D, 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. |
| Alcoholic Hepatitis | Symptoms are similar to the ones of hepatitis D, 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. |
Differential diagnosis of jaundice are: [3][4][5][6][7]
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References
- ↑ "Hepatitis D" (PDF).
- ↑ "Hepatitis D (CDC)".
- ↑ Fargo MV, Grogan SP, Saguil A (2017). "Evaluation of Jaundice in Adults". Am Fam Physician. 95 (3): 164–168. PMID 28145671.
- ↑ Leevy CB, Koneru B, Klein KM (1997). "Recurrent familial prolonged intrahepatic cholestasis of pregnancy associated with chronic liver disease". Gastroenterology. 113 (3): 966–72. PMID 9287990.
- ↑ Hov JR, Boberg KM, Karlsen TH (2008). "Autoantibodies in primary sclerosing cholangitis". World J. Gastroenterol. 14 (24): 3781–91. PMC 2721433. PMID 18609700.
- ↑ Bond LR, Hatty SR, Horn ME, Dick M, Meire HB, Bellingham AJ (1987). "Gall stones in sickle cell disease in the United Kingdom". Br Med J (Clin Res Ed). 295 (6592): 234–6. PMC 1247079. PMID 3115390.
- ↑ Malakouti M, Kataria A, Ali SK, Schenker S (2017). "Elevated Liver Enzymes in Asymptomatic Patients - What Should I Do?". J Clin Transl Hepatol. 5 (4): 394–403. doi:10.14218/JCTH.2017.00027. PMC 5719197. PMID 29226106.