Hepatitis
Classification & external resources

Alcoholic hepatitis evident by fatty change, cell necrosis, Mallory bodies
ICD-10	K75.9
ICD-9	573.3
DiseasesDB	20061
MeSH	D006505

Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. Etymologically from ancient Greek hepar (ηπαρ) or hepato- (ηπατο-) meaning 'liver' and suffix -itis denoting 'inflammation' (c.1727^[1]). The condition can be self limiting, healing on its own or can progress to scarring of the liver. Acute hepatitis is when it lasts less than 6 months and chronic hepatitis is when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of liver damage worldwide. Hepatitis can also be due to toxins (notably alcohol), other infections or from autoimmune process. It may run a subclinical course when the affected person may not feel ill. The patient becomes unwell and symptomatic when the disease impairs liver functions that include, among other things, screening of harmful substances, regulation of blood composition, and production of bile to help digestion. Image File history File linksMetadata No higher resolution available. ... Alcoholic liver disease is the major cause of liver disease in Western countries, (in Asian countries, viral hepatitis is the major cause). ... Necrosis (in Greek Νεκρός = Dead) is the name given to accidental death of cells and living tissue. ... Mallory bodies (also known as alcoholic hyaline or Mallorys hyaline) are pathologic inclusions found in the cytoplasm of liver cells. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // K00-K93 - Diseases of the digestive system (K00-K14) Diseases of oral cavity, salivary glands and jaws (K00) Disorders of tooth development and eruption (K01) Embedded and impacted teeth (K02) Dental caries (K03) Other diseases of hard tissues of teeth (K04) Diseases of pulp and periapical tissues (K040) Pulpitis (K05... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... For the bird, see Liver bird. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... Drawing of the structure of cork as it appeared under the microscope to Robert Hooke from Micrographia which is the origin of the word cell being used to describe the smallest unit of a living organism Cells in culture, stained for keratin (red) and DNA (green) The cell is the... Biological tissue is a group of cells that perform a similar function. ... Etymology is the study of the origins of words. ... Note: This article contains special characters. ... Stop editing pages god ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... In medicine, a subclinical infection refers to an inapparent, asymptomatic infection, or an infection that has such a mild course that it doesnt alert the patient enough to consult with a physician. ... Illness (sometimes referred to as ill-health) can be defined as a state of poor health. ... A patient having his blood pressure taken by a doctor. ... The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ...

Causes

Acute hepatitis

• Viral Hepatitis: Hepatitis A and E (more than 95% of viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow fever virus, adenoviruses.
• Non viral infection: toxoplasma, Leptospira, Q fever,^[2] rocky mountain spotted fever^[3]
• Alcohol
• Toxins: Amanita toxin in mushrooms, Carbon tetrachloride, asafetida
• Drugs: Paracetamol, amoxycillin, anti tuberculosis medicines, minocycline and many others (see longer list below).
• Circulatory insufficiency
• Pregnancy
• Auto immune conditions e.g. Systemic Lupus Erythematosus (SLE)
• Metabolic diseases e.g. Wilson's disease

Chronic hepatitis

• Viral Hepatitis: Hepatitis B with or without hepatitis D, Hepatitis C (Hepatitis A and E do not lead to chronic disease)
• Autoimmune: Autoimmune hepatitis
• Alcohol
• Drugs: methyl-dopa, nitrofurantoin, isoniazide, ketoconazole
• Non-alcoholic steatohepatitis
• Heredity: Wilson's disease, alpha 1-antitrypsin deficiency
• Primary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis^[4]

This article is about the disease. ... Species see text Cytomegalovirus (CMV) (from the Greek cyto-, cell, and -mega-, large) is a viral genus of the Herpesviruses group: in humans it is commonly known as human herpesvirus 5 (HHV-5). ... The Epstein-Barr virus (EBV), also called Human herpesvirus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and one of the most common viruses in humans. ... Yellow fever (also called black vomit or sometimes The American Plague) is an acute viral disease. ... Genera Aviadenovirus Atadenovirus Mastadenovirus Siadenovirus Adenoviruses are viruses of the family Adenoviridae. ... Binomial name Toxoplasma gondi (Nicolle & Manceaux), 1908 Toxoplasma gondii is a species of parasitic protozoa, belonging to the Apicomplexa, that can cause the disease toxoplasmosis in humans. ... Species Leptospira is a genus of spirochaete bacteria, including a small number of pathogenic and saprotrophic microorganisms. ... Binomial name Wolbach, 1919 Rocky Mountain spotted fever is the most severe and most frequently reported rickettsial illness in the United States, and has been diagnosed throughout the Americas. ... Species 600, see List of Amanita species Synonyms Aspidella The genus Amanita contains about 600 species of agarics including some of the most toxic known mushrooms found worldwide. ... Binomial name Ferula assafoetida L. Asafoetida (Ferula assafoetida, family Apiaceae) is a species of Ferula native to Iran. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... A metabolic disorder is a medical disorder which affects the production of energy within individual human (or animal) cells. ... Wilsons disease or hepatolenticular degeneration is an autosomal recessive hereditary disease, with an incidence of about 1 in 30,000 in most parts of the world and a male preponderance. ... In medicine (gastroenterology), hepatitis is any disease featuring inflammation of the liver. ... As its name signifies, Non-alcoholic steatohepatitis (NASH) or Nonalcoholic Fatty Liver Disease (NAFLD) is fatty inflammation of the liver when this is not due to excessive alcohol use. ... See Heredity (disambiguation) for other meanings. ... Alpha 1-antitrypsin deficiency (A1AD or Alpha-1) is a genetic disorder caused by defective production of alpha 1-antitrypsin, deficient activity in the blood and lungs, and deposition of excessive amounts of abnormal A1AT protein in liver cells. ... This article or section does not cite its references or sources. ... Primary sclerosing cholangitis (PSC) is a form of cholangitis due to an autoimmune reaction. ...

Signs and symptoms

Acute Hepatitis

Clinically, the course of acute hepatitis varies widely from mild symptoms requiring no treatment to fulminant hepatic failure needing liver transplantation. Acute viral hepatitis are more likely to be asymptomatic in younger people. Symptomatic individuals may present after convalescent stage of 7 to 10 days, with the total illness lasting 2 to 6 weeks.^[4] Liver failure is the final stage of liver disease. ...

Initial features are of nonspecific flu-like symptoms, common to almost all acute viral infections and may include malaise, muscle and joint aches, fever, nausea or vomiting, diarrhea, and headache. More specific symptoms, which can be present in acute hepatitis from any cause are: profound loss of appetite, aversion to smoking among smokers, dark urine, yellowing of the eyes and skin (i.e. jaundice) and abdominal discomfort. Physical findings are usually minimal, apart from jaundice (33%) and tender hepatomegaly (10%). There can be occasional lymphadenopathy (5%) or splenomegaly (5%).^[5] Malaise is a feeling of general discomfort or uneasiness, an out of sorts feeling, often the first indication of an infection or other disease. ... An analogue medical thermometer showing the temperature of 38. ... For other uses, see Nausea (disambiguation). ... Emesis redirects here. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Anorexia (deriving from the Greek α(ν)- (a(n)-, a prefix that denotes absence) + όρεξη (orexe) = appetite) is the decreased sensation of appetite. ... Look up jaundice in Wiktionary, the free dictionary. ... For the human abdomen, see human abdomen. ... Hepatomegaly is the condition of having an enlarged liver. ... Lymphadenopathy is a term meaning disease of the lymph nodes. ... Splenomegaly is an enlargement of the spleen, which usually lies in the left upper quadrant (LUQ) of the human abdomen. ...

Chronic Hepatitis

Majority of patients will remain asymptomatic or mildly symptomatic, abnormal blood tests being the only manifestation. Features may be related to extent of liver damage or the cause of hepatitis. Many experience return of symptoms related to acute hepatitis. Jaundice can be a late feature and may indicate extensive damage. Other features include abdominal fullness from enlarged liver or spleen, low grade fever and fluid retention (ascites). Extensive damage and scarring of liver i.e. cirrhosis leads to weight loss, easy bruising and bleeding tendencies. Acne, abnormal menstruation, lung scarring, inflammation of the thyroid gland and kidneys may be present in women with autoimmune hepatitis.^[6] For the bird, see Liver bird. ... The spleen is an organ located in the abdomen, where it functions in the destruction of old red blood cells and holding a reservoir of blood. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Not to be confused with Mensuration. ... The thyroid gland and its relations In anatomy, the thyroid (IPA θaɪɹoɪd) is an endocrine gland. ...

Findings on clinical examination are usually those of cirrhosis or are related to aetiology. Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Etiology (alternately aetiology, aitiology) is the study of Greek words aitia = cause and logos = word/speech) is used in philosophy, physics and biology in reference to the causes of various phenomena. ...

Types of hepatitis

Please see the respective articles for more detailed information.

See also: Infectious canine hepatitis

Infectious canine hepatitis is an acute liver infection in dogs caused by canine adenovirus type-1 (CAV-1). ...

Viral

Most cases of acute hepatitis are due to viral infections:

• Hepatitis A
• Hepatitis B
• Hepatitis C
• Hepatitis B with D
• Hepatitis E
• Hepatitis F (existence unknown)
• Hepatitis G
• In addition to the hepatitis viruses (please note that the hepatitis viruses are not all related). Other viruses can also cause hepatitis, including cytomegalovirus, Epstein-Barr virus, yellow fever, etc.

Species Hepatitis A virus Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the liver caused by the hepatovirus hepatitis A virus. ... “HBV” redirects here. ... This page is for the disease. ... Hepatitis D is a disease caused by a small circular RNA virus (Hepatitis delta virus); this virus is replication defective and therefore cannot propagate in the absence of another virus. ... Hepatitis E is an acute viral hepatitis (liver inflammation) caused by infection with a virus called hepatitis E virus (HEV). ... Hepatitis F is a hypothetical virus linked to hepatitis. ... Hepatitis G and GB virus C (GBV-C) are RNA viruses that were independently identified in 1995, and were subsequently found to be two isolates of the same virus. ... Species see text Cytomegalovirus (CMV) (from the Greek cyto-, cell, and -mega-, large) is a viral genus of the Herpesviruses group: in humans it is commonly known as human herpesvirus 5 (HHV-5). ... The Epstein-Barr virus (EBV), also called Human herpesvirus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and is one of the most common viruses in humans. ...

Hepatitis A

Hepatitis A or infectious jaundice is caused by a picornavirus. It is transmitted by the orofecal route, transmitted to humans through methods such as contaminated food. It causes an acute form of hepatitis and does not have a chronic stage. The patient's immune system makes antibodies against hepatitis A that confer immunity against future infection. People with hepatitis A are advised to rest, stay hydrated and avoid alcohol. A vaccine is available that will prevent infection from hepatitis A for life. Hepatitis A can be spread through personal contact, consumption of raw sea food or drinking contaminated water. This occurs primarily in third world countries. Strict personal hygiene and the avoidance of raw and unpeeled foods can help prevent an infection. Infected people excrete the hepatitis A virus with their faeces two weeks before and one week after the appearance of jaundice. The time between the infection and the start of the illness can run from 15 to 45 days, and approximately 15% of sufferers may experience relapsing symptoms from six months to a year following initial diagnosis. Species Hepatitis A virus Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the liver caused by the hepatovirus hepatitis A virus. ... Genera Enterovirus Rhinovirus Hepatovirus Cardiovirus Apthovirus Parechovirus Erbovirus Kobuvirus Teschovirus Picornaviruses are viruses that belong to the family Picornaviridae. ... Transmission of a substance, usually pathogenic, from faecal secretions into the body orally. ... Wikipedia does not yet have an article with this exact name. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ...

Hepatitis B

Hepatitis B is caused by a hepadnavirus, which can cause both acute and chronic hepatitis. Chronic hepatitis develops in the 15% of patients who are unable to eliminate the virus after an initial infection. Identified methods of transmission include blood (blood transfusion, now rare), tattoos (both amateur and professionally done), sexually (through sexual intercourse or through contact with blood or bodily fluids), or via mother to child by breast feeding (minimal evidence of transplacental crossing). However, in about half of cases the source of infection cannot be determined. Blood contact can occur by sharing syringes in intravenous drug use, shaving accessories such as razor blades, or touching wounds on infected persons. Needle-exchange programmes have been created in many countries as a form of prevention. Patients with chronic hepatitis B have antibodies against hepatitis B, but these antibodies are not enough to clear the infection that establishes itself in the DNA of the affected liver cells. The continued production of virus combined with antibodies is a likely cause of immune complex disease seen in these patients. A vaccine is available that will prevent infection from hepatitis B for life. Hepatitis B infections result in 500,000 to 1,200,000 deaths per year worldwide due to the complications of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis B is endemic in a number of (mainly South-East Asian) countries, making cirrhosis and hepatocellular carcinoma big killers. There are six FDA-approved treatment options available for persons with a chronic hepatitis B infection: alpha-interferon, pegylated interferon adefovir, entecavir, telbivudine and lamivudine. About 45% of persons on treatment achieve a sustained response. “HBV” redirects here. ... Genera Orthohepadnavirus Avihepadnavirus Hepadnaviruses are the viruses in the family Hepadnaviridae. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... Blood transfusion is the process of transferring blood or blood-based products from one person into the circulatory system of another. ... For other uses, see Tattoo (disambiguation). ... A sexually transmitted disease (STD), a. ... A syringe nowadays nearly always means a medical syringe, but it can mean any of these: A simple hand-powered piston pump consisting of a plunger that can be pulled and pushed along inside a cylindrical tube (the barrel), which has a small hole on one end, so it can... An intravenous drug (IV drug) is a drug administered intravenously, either by an intravenous drip or a syringe. ... A needle-exchange programme is a controversial social policy, based on the philosophy of harm reduction, whereby people can obtain hypodermic needles and syringes without a prescription for little or no cost. ... The structure of part of a DNA double helix Deoxyribonucleic acid, or DNA, is a nucleic acid molecule that contains the genetic instructions used in the development and functioning of all known living organisms. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Hepatocellular carcinoma (HCC, also called hepatoma) is a primary malignancy (cancer) of the liver. ... Location of Southeast Asia Southeast Asia is a subregion of Asia. ... In public health, a big killer is a disease or other major cause of loss of human life. ... Adefovir dipivoxil, previously called bis-POM PMEA, is an orally-administered nucleotide analogue reverse transcriptase inhibitor (NtRTI), which works by blocking DNA polymerase, an enzyme that is crucial for the hepatitis B virus (HBV) to reproduce in the body. ... Lamivudine (2,3-dideoxy-3-thiacytidine, commonly called 3TC) is a potent nucleoside analog reverse transcriptase inhibitor (nRTI). ...

Hepatitis C

Hepatitis C (originally "non-A non-B hepatitis") is caused by a Flavivirus. It can be transmitted through contact with blood (including through sexual contact where the two parties' blood is mixed) and can also cross the placenta. Hepatitis C may lead to a chronic form of hepatitis, culminating in cirrhosis. It can remain asymptomatic for 10-20 years. Patients with hepatitis C are susceptible to severe hepatitis if they contract either hepatitis A or B, so all hepatitis C patients should be immunized against hepatitis A and hepatitis B if they are not already immune. The virus can cause cirrhosis of the liver. HCV viral levels can be reduced to undetectable levels by a combination of interferon and the antiviral drug ribavirin. The genotype of the virus determines the rate of response to this treatment regimen. Genotype 1 is more resistant to interferon therapy than other HCV genotypes. This page is for the disease. ... Species see text Flavivirus is a genus of the family Flaviviridae. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Interferons (IFNs) are natural proteins produced by the cells of the immune system of most vertebrates in response to challenges by foreign agents such as viruses, bacteria, parasites and tumor cells. ... Ribavirin (Copegus®; Rebetol®; Ribasphere®; Vilona®,Virazole®, also generics from Sandoz, Teva, Warrick) is an anti-viral drug which is active against a number of DNA and RNA viruses. ... This article does not cite any references or sources. ...

Hepatitis D

Hepatitis D is considered a subviral satellite, as it can only propagate in the presence of the Hepatitis B virus. Hepatitis D is a disease caused by a small circular RNA virus (Hepatitis delta virus); this virus is replication defective and therefore cannot propagate in the absence of another virus. ... “HBV” redirects here. ...

Hepatitis E

Hepatitis E produces symptoms similar to hepatitis A, although it can take a fulminant course in some patients, particularly pregnant women; it is more prevalent in the Indian subcontinent. Hepatitis E is an acute viral hepatitis (liver inflammation) caused by infection with a virus called hepatitis E virus (HEV). ... Species Hepatitis A virus Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the liver caused by the hepatovirus hepatitis A virus. ... This article is about human pregnancy in biological females. ... Map of South Asia (see note) This article deals with the geophysical region in Asia. ...

Hepatitis F

Hepatitis F is a hypothetical virus linked to hepatitis. Several hepatitis F candidates emerged in the 1990s; none of these reports have been substantiated. Hepatitis F is a hypothetical virus linked to hepatitis. ...

Hepatitis G

Another type of hepatitis, hepatitis G, has been identified,^[7] and is probably spread by blood and sexual contact.^[8] There is, however, doubt about whether it causes hepatitis, or is just associated with hepatitis, as it does not appear to be primarily replicated in the liver.^[9] Hepatitis G and GB virus C (GBV-C) are RNA viruses that were independently identified in 1995, and were subsequently found to be two isolates of the same virus. ...

Other viral infections can cause hepatitis (inflammation of the liver):

• Mumps virus
• Rubella virus
• Cytomegalovirus
• Epstein-Barr virus
• Other herpes viruses

For the computer language of the same name, see MUMPS. Mumps or Epidemic parotitis is a viral disease of humans. ... Rubella (also known as epidemic roseola, German measles or three-day measles) is a disease caused by the Rubella virus. ... Species see text Cytomegalovirus (CMV) (from the Greek cyto-, cell, and -mega-, large) is a viral genus of the Herpesviruses group: in humans it is commonly known as human herpesvirus 5 (HHV-5). ... The Epstein-Barr virus (EBV), also called Human herpesvirus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and is one of the most common viruses in humans. ...

Alcoholic hepatitis

Main article: Alcoholic hepatitis

Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. Usually alcoholic hepatitis comes after a period of increased alcohol consumption. Alcoholic hepatitis is characterized by a variable constellation of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can vary from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset. Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. ... Grain alcohol redirects here. ... Alcoholic beverages An alcoholic beverage is a drink containing ethanol, commonly known as alcohol, although in chemistry the definition of alcohol includes many other compounds. ... The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. ... Obtunded refers to a patient that has less than full mental capacity, typically as a result of a medical condition or trauma. ... Bilirubin is a yellow breakdown product of normal heme catabolism. ...

Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C. The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis in Western countries. Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ...

Drug induced hepatitis

A large number of drugs can cause hepatitis. The anti-diabetic drug troglitazone was withdrawn in 2000 for causing hepatitis. Other drugs associated with hepatitis:^[10] An anti-diabetic drug or oral hypoglycemic agent is used to treat diabetes mellitus. ... Troglitazone (Rezulin®, Resulin® or Romozin®) is a member of the drug class of the thiazolidinediones. ... Year 2000 (MM) was a leap year starting on Saturday (link will display full 2000 Gregorian calendar). ...

• Allopurinol
• Amitriptyline (antidepressant)
• Amiodarone (antiarrhythmic)
• Azathioprine^[11][12]
• Halothane (a specific type of anesthetic gas)
• Hormonal contraceptives
• Ibuprofen and indomethacin (NSAIDs)
• Isoniazid (INH), rifampicin, and pyrazinamide (tuberculosis-specific antibiotics)
• Ketoconazole (antifungal)
• Methyldopa (antihypertensive)
• Minocycline (tetracycline antibiotic)
• Nifedipine (antihypertensive)
• Nitrofurantoin (antibiotic)
• Phenytoin and valproic acid (antiepileptics)
• Zidovudine (antiretroviral i.e. against HIV)
• Some herbs and nutritional supplements

The clinical course of drug-induced hepatitis is quite variable, depending on the drug and the patient's tendency to react to the drug. For example, halothane hepatitis can range from mild to fatal as can INH-induced hepatitis. Hormonal contraception can cause structural changes in the liver. Amiodarone hepatitis can be untreatable since the long half life of the drug (up to 60 days) means that there is no effective way to stop exposure to the drug. Statins can cause elevations of liver function blood tests normally without indicating an underlying hepatitis. Lastly, human variability is such that any drug can be a cause of hepatitis. Allopurinol is a drug used primarily to treat conditions arising from excess uric acid, most notably chronic gout. ... Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. ... Azathioprine is a chemotherapy drug, now rarely used for chemotherapy but more for immunosuppression in organ transplantation, autoimmune disease such as rheumatoid arthritis or inflammatory bowel disease such as Crohns disease. ... Halothane vapour is an inhalational general anaesthetic. ... Hormonal contraception refers to birth control methods that act on the hormonal system. ... Ibuprofen (INN) (IPA: ) (from the earlier nomenclature iso-butyl-propanoic-phenolic acid) is a non-steroidal anti-inflammatory drug (NSAID) originally marketed as Nurofen and since under various trademarks, including Act-3, Advil, Brufen, Dorival, Herron Blue, Panafen, Motrin, Nuprin and Burana (Finland), Ipren or Ibumetin (Denmark and Sweden), Ibuprom... Indomethacin (USAN) or indometacin (INN) is a non-steroidal anti-inflammatory drug commonly used to reduce fever, pain, stiffness, and swelling. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Isoniazid (also called isonicotinyl hydrazine or isonicotinic acid hydrazide); abbreviated INH or just H. Isoniazid is a first-line antituberculous medication used in the prevention and treatment of tuberculosis. ... Rifampicin (INN) (IPA: ) or rifampin (USAN) is a bacteriocidal antibiotic drug of the rifamycin group. ... Pyrazinamide is a drug used to treat tuberculosis in afflicted patients. ... Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ... Staphylococcus aureus - Antibiotics test plate. ... Ketoconazole is a synthetic antifungal drug used to prevent and treat skin and fungal infections, especially in immunocompromised patients such as those with AIDS. Due to its side-effect profile, it has been superseded by newer antifungals, such as fluconazole and itraconazole. ... Something antifungal kills or inhibits the growth of fungus. ... Methyldopa or alpha-methyldopa (brand names Aldomet, Apo-Methyldopa, Dopamet, Novomedopa) is a centrally-acting antiadrenergic antihypertensive medication. ... Antihypertensives are a class of drugs that are used in medicine and pharmacology to treat hypertension (high blood pressure). ... Minocycline hydrochloride, also known as minocycline, is a member of the broad spectrum tetracycline antibiotics, and has a broader spectrum than the other members. ... The 4 rings of the basic tetracycline structure. ... Nifedipine (brand name Adalat and Procardia) is a dihydropyridine calcium channel blocker. ... Nitrofurantoin is an antibiotic. ... Staphylococcus aureus - Antibiotics test plate. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy and bipolar disorder. ... Zidovudine (INN) or azidothymidine (AZT) (also called ZDV) is an antiretroviral drug, the first one approved for treatment of HIV. It is also sold under the names Retrovir® and Retrovis®, and as an ingredient in Combivir® and Trizivir®. It is an analog of thymidine. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... Halothane vapour is an inhalational general anaesthetic. ... INH Stands for Inset Name Here, a spam forum on the Transformers discussion board www. ... Hormonal contraception refers to birth control methods that act on the hormonal system. ... Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. ... This article is about the computer game. ... Lovastatin, the first statin to be marketed The statins (or HMG-CoA reductase inhibitors) form a class of hypolipidemic agents, used as pharmaceutical agents to lower cholesterol levels in people with or at risk for cardiovascular disease. ...

Other toxins that cause hepatitis

Toxins and drugs can cause hepatitis:

• Amatoxin-containing mushrooms, including the Death Cap (Amanita phalloides), the Destroying Angel (Amanita ocreata), and some species of Galerina. A portion of a single mushroom can be enough to be lethal (10 mg or less of α-amanitin).
• White phosphorus, an industrial toxin.
• Paracetamol (acetaminophen in the United States) can cause hepatitis when taken in an overdose. The severity of liver damage can be limited by prompt administration of acetylcysteine.
• Carbon tetrachloride ("tetra", a dry cleaning agent), chloroform, and trichloroethylene, all chlorinated hydrocarbons, cause steatohepatitis (hepatitis with fatty liver).
• Cylindrospermopsin, a toxin from the cyanobacterium Cylindrospermopsis raciborskii and other cyanobacteria.

Amatoxins are a subgrup of toxins found in Amanita phalloides and also in Galerina and Lepiota mushroom species. ... Binomial name Amanita phalloides (Vaill. ... Binomial name Amanita virosa Lam. ... General Name, symbol, number phosphorus, P, 15 Chemical series nonmetals Group, period, block 15, 3, p Appearance waxy white/ red/ black/ colorless Standard atomic weight 30. ... Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ... Acetylcysteine (rINN) (IPA: ), also known as N-acetylcysteine (abbreviated NAC), is a pharmacological agent used mainly as a mucolytic and in the management of paracetamol overdose. ... R-phrases , , , , S-phrases , , , , , Flash point Non flammable Supplementary data page Structure and properties n, εr, etc. ... Dry cleaning is any cleaning process for clothing and textiles using an organic solvent other than water — generally known as dry cleaning fluid, and typically this is tetrachloroethylene. ... R-phrases , , , S-phrases , Flash point Non-flammable U.S. Permissible exposure limit (PEL) 50 ppm (240 mg/m3) (OSHA) Supplementary data page Structure and properties n, εr, etc. ... The chemical compound trichloroethylene is a chlorinated hydrocarbon commonly used as an industrial solvent. ... Chlorinated hydrocarbons are a broad class of organic chemicals used mainly as solvents but also with many other uses. ... Different stages of liver damage Fatty liver (also known as steatorrhoeic hepatosis or steatosis hepatis) is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis. ... Chemical structure of Cylindrospermopsin Cylindrospermopsin is a toxin of the cyanobacteria Cylindrospermopsin raciborskii or Microcystis aeruginosa. ... Cyanobacteria (Greek: cyanos = blue) are a phylum of aquatic bacteria that obtain their energy through photosynthesis. ...

Metabolic disorders

Some metabolic disorders cause different forms of hepatitis. Hemochromatosis (due to iron accumulation) and Wilson's disease (copper accumulation) can cause liver inflammation and necrosis. Haemochromatosis, also spelled hemochromatosis, is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. ... For other uses, see Iron (disambiguation). ... Wilsons disease or hepatolenticular degeneration is an autosomal recessive hereditary disease, with an incidence of about 1 in 30,000 in most parts of the world and a male preponderance. ... For other uses, see Copper (disambiguation). ... Necrosis (in Greek Νεκρός = Dead) is the name given to accidental death of cells and living tissue. ...

See below for non-alcoholic steatohepatitis (NASH), effectively a consequence of metabolic syndrome. As its name signifies, Non-alcoholic steatohepatitis (NASH) or Nonalcoholic Fatty Liver Disease (NAFLD) is fatty inflammation of the liver when this is not due to excessive alcohol use. ... Metabolic syndrome is a combination of medical disorders that increase ones risk for cardiovascular disease and diabetes. ...

Obstructive

"Obstructive jaundice" is the term used to describe jaundice due to obstruction of the bile duct (by gallstones or external obstruction by cancer). If longstanding it leads to destruction and inflammation of liver tissue. A bile duct is any of a number of long tube-like structures that carry bile. ... This article does not cite any references or sources. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ...

Autoimmune

Anomalous presentation of human leukocyte antigen (HLA) class II on the surface of hepatocytes—possibly due to genetic predisposition or acute liver infection—causes a cell-mediated immune response against the body's own liver, resulting in autoimmune hepatitis. HLA region of Chromosome 6 The human leukocyte antigen system (HLA) is the name of the human major histocompatibility complex (MHC). ... Sinusoid of a rat liver with fenestrated endothelial cells. ... For other uses, see Gene (disambiguation). ... A request has been made on Wikipedia for this article to be deleted in accordance with the deletion policy. ...

Autoimmune hepatitis has an incidence of 1-2 per 100,000 per year, and a prevalence of 15-20/100,000. As with most other autoimmune diseases, it affects women much more often than men (8:1). Liver enzymes are elevated, as is bilirubin. Autoimmune hepatitis can progress to cirrhosis. Treatment is with steroids and disease-modifying antirheumatic drugs (DMARDs). Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Liver function tests (LFTs or LFs), are groups of clinical biochemistry laboratory blood assays designed to give a doctor or other health professional information about the state of a patients liver. ... Bilirubin is a yellow breakdown product of normal heme catabolism. ... This article is about the chemical family of steroids. ... Disease-modifying antirheumatic drugs is a category of drugs used in many autoimmune diseases to slow down disease progression. ...

The diagnosis of autoimmune hepatitis is best achieved with a combination of clinical and laboratory findings. A number of specific antibodies found in the blood (antinuclear antibody (ANA), smooth muscle antibody (SMA), Liver/kidney microsomal antibody (LKM-1) and anti-mitochondrial antibody (AMA)) are of use, as is finding an increased Immunoglobulin G level. However, the diagnosis of autoimmune hepatitis always requires a liver biopsy. In complex cases a scoring system can be used to help determine if a patient has autoimmune hepatitis, which combines clinical and laboratory features of a given case. This article does not cite any references or sources. ... Smooth muscle Layers of Esophageal Wall: 1. ... The kidneys are the organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... In cell biology, a mitochondrion is an organelle found in the cells of most eukaryotes. ... Schematic of antibody binding to an antigen An antibody is a protein complex used by the immune system to identify and neutralize foreign objects like bacteria and viruses. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Four subtypes are recognised, but the clinical utility of distinguishing subtypes is limited.

1. Positive ANA and SMA, raised immunoglobulin G (classic form, responds well to low dose steroids)
2. Positive LKM-1 (typically female children and teenagers; disease can be severe)
3. All antibodies negative, positive antibodies against soluble liver antigen (SLA)(now designated SLP/LP). This group behaves like group 1.
4. No autoantibodies detected (~13%)

Alpha 1-antitrypsin deficiency

In severe cases of alpha 1-antitrypsin deficiency (A1AD), the accumulated protein in the endoplasmic reticulum causes liver cell damage and inflammation. Alpha 1-antitrypsin deficiency (A1AD or Alpha-1) is a genetic disorder caused by defective production of alpha 1-antitrypsin, deficient activity in the blood and lungs, and deposition of excessive amounts of abnormal A1AT protein in liver cells. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... The endoplasmic reticulum or ER is an organelle found in all eukaryotic cells that is an interconnected network of tubules, vesicles and cisternae that is responsible for several specialized functions: Protein translation, folding, and transport of proteins to be used in the cell membrane (e. ...

Nonalcoholic steatohepatitis

Non-alcoholic steatohepatitis (NASH) is a type of hepatitis which resembles alcoholic hepatitis on liver biopsy (fat droplets, inflammatory cells, but usually no Mallory's hyaline) but occurs in patients who have no known history of alcohol abuse. NASH is more common in women and the most common cause is obesity or the metabolic syndrome. A related but less serious condition is called "fatty liver" (steatosis hepatis), which occurs in up to 80% of all clinically obese people. A liver biopsy for fatty liver shows fat droplets throughout the liver, but no signs of inflammation or Mallory's hyalin. As its name signifies, Non-alcoholic steatohepatitis (NASH) or Nonalcoholic Fatty Liver Disease (NAFLD) is fatty inflammation of the liver when this is not due to excessive alcohol use. ... Mallory bodies (also known as alcoholic hyaline or Mallorys hyaline) are pathologic inclusions found in the cytoplasm of liver cells. ... Metabolic syndrome is a combination of medical disorders that increase ones risk for cardiovascular disease and diabetes. ...

The diagnosis depends on history, physical exam, blood tests, radiological imaging and sometimes a liver biopsy. The initial evaluation to identify the presence of fatty infiltration of the liver is radiologic imaging including ultrasound, computed tomographic imaging, or magnetic resonance imaging. However, radiologic imaging cannot readily identify inflammation in the liver. Therefore, the differentiation between steatosis and NASH often requires a liver biopsy. It can also be difficult to distinguish NASH from alcoholic hepatitis when the patient has a history of alcohol consumption. Sometimes in such cases a trial of abstinence from alcohol along with follow -up blood tests and a repeat liver biopsy are required. Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Image A: A normal chest X-ray. ... Sonography redirects here. ... CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... MRI redirects here. ...

NASH is becoming recognized as the most important cause of liver disease second only to Hepatitis C in numbers of patients going on to cirrhosis. Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ...

Hepatitis awareness

World Hepatitis Awareness Day is an annual event organised by several worldwide hepatitis advocacy groups to raise awareness of infectious hepatitis and demand action to curb the spread of the disease and treat people who are infected. To meet Wikipedias quality standards, this article or section may require cleanup. ...

References

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 313th day of the year (314th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 182nd day of the year (183rd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 181st day of the year (182nd in leap years) in the Gregorian calendar. ...

External links

• World Hepatitis Awareness Day
• WHO fact sheet of hepatitis
• American Liver Society
• Viral Hepatitis at the Centers for Disease Control
• Hepatitis Neighborhood
• Autoimmune Hepatitis Calculator
• American Liver Foundation: Comprehensive information about hepatitis, including links to chapters for finding local resources
• Children's Liver Disease Foundation
• Hepatitis Help - General Information about Hepatitis