Nonviral hepatitis: inflammation of the liver usually
resulting from exposure to certain toxins or drugs. In toxic hepatitis,
liver damage (diffuse fatty infiltration of liver cells and necrosis)
usually occurs within 24 to 48 hours after exposure to toxic agents.
Alcohol, anoxia, and preexisting liver disease exacerbate the toxic effects
of some of these agents. Recovery from nonviral hepatitis for most
patients is good, although a few develop fulminating hepatitis or cirrhosis.
Cause: Toxic hepatitis may result from exposure to various
hepatotoxins, such as acetaminophen, carbon tetrachloride, poisonous mushrooms,
or vinyl chloride. Drug induced hepatitis may result from a hypersensitivity
reaction unique to the affected patient such as, sulfonamides and, phenothiazines
(cholestasis-induced hepatitis).
Symptoms:
Anorexia
nausea and vomiting
Jaundice
Dark urine
Hepatomegaly (enlarge liver)
May have abdominal pain.
With the cholestatic form, clay colored stools and pruritus may occur.
Treatment:
Effective treatment aims to remove the causative agent by lavage( the
irrigation or washing out of an organ), catharsis (a cleansing or purgation),
or hyperventilation, depending on the route of exposure.
For gold or arsenic : Dimercaprol is an antidote used for toxic
hepatitis cause by these but does not prevent drug induced hepatitis caused
by other substances.
Corticosteroids may be ordered for patients with the drug induced type.
Thioctic acid may be prescribed to alleviate mushroom poisoning.
Viral Hepatitis:
The viral form of hepatitis is an acute inflammation of the liver marked
by liver cell destruction, necrosis, and autolysis ( spontaneous disintegration
of cells or tissues by autologous enzymes ). There are three types
of viral hepatitis: Type A (infectious or short incubation
hepatitis), Type B (serum or long incubation hepatitis), and Type
C (non-A, non-B) hepatitis. Recently a hepatitis Type D virus
has been identified. However, this defective ribonucleic acid virus
only expresses itself with active hepatitis B.
Cause: By hepatitis viruses
Symptoms:
Preicteric phase (preceding
the appearance of jaundice-yellowing of the skin): the patient may
complain of fatigue, malaise, arthralgia (pain in a joint), myalgia (muscular
pain), photophobia (abnormal visual intolerance to light), and headache.
The patient may also experience nausea and vomiting,
fever, liver and lymph node enlargement. His sense of taste and smell
may be alter.
Icteric phase (jaundice-icterus stage)
this phase lasts 2 to 2 weeks. The patient may experience mild
weight loss, dark urine, clay colored stools, yellow sclera and skin, and
continued hepatomegaly with tenderness.
Convalescent Phase lasts 2 to 12
weeks or possibly longer. The patient may continue to feel fatigue,
have abdominal pain or tenderness, flatulence, and indigestion.
Treatment:
There is no specific treatment that exists for
hepatitis.
Rest and combat anorexia by eating small meals
high in calories and protein for the early stages of this disease.
Antiemetic may be prescribed for nausea and prevent
vomiting.
In severe hepatitis: Corticosteroids may
be prescribed.
Hepatitis Type A: (infectious)
Age of incidence: Children and young adults
Seasonal Incidence: Fall and Winter
Transmission: Food, water, semen, tears, stools, and possibly
urine
Incubation: 15 to 45 days
Onset: Sudden
Serum markers: Antibody to type A hepatitis
Prognosis: Good
Carrier state: NO
Age incidence: Can occur at any age
Seasonal Incidence: Anytime
Transmission: Serum, blood and blood products, and semen
Incubation: 40 to 180 days
Onset: Insidious
Serum markers: Hepatitis B surface antigen and hepatitis
B antibodies
Prognosis: Worsens with age
Carrier state: Yes
Hepatitis Type C (non-A, non-B)
Age incidence: Adults
Seasonal Incidence: Anytime
Transmission: Serum, blood and blood products, and possibly
food
Incubation: 15 to 160 days
Onset: Insidious
Serum markers: –
Prognosis: Moderate
Carrier state: Unknown