VIRAL HEPATITIS
Viral hepatitis can be
asymptomatic or it can present with malaise and weakness, nausea and anorexia,
jaundice, or dark urine. Lab studies show markedly elevated alanine
aminotransferase (ALT) and aspartate aminotransferase (AST). Diagnosis is by
serology.
Acute viral hepatitis is viral hepatitis with signs
and symptoms for <6 months. It can be caused by any of the
hepatitis viruses.
Microscopically, the liver
shows lobular disarray, hepatocyte swelling (balloon cells), apoptotic
hepatocytes (Councilman bodies), lymphocytes in portal tracts and in the
lobule, hepatocyte regeneration, and cholestasis.
Chronic viral hepatitis is viral hepatitis with signs
and symptoms for >6 months. It can be caused by hepatitis
viruses B, C, and D.
•
Microscopically, chronic
persistent hepatitis shows inflammation confined to portal tracts.
•
Chronic
active hepatitis shows inflammation spilling into the parenchyma, causing interface hepatitis (piecemeal necrosis
of limiting plate).
Hepatitis B often has “ground
glass” hepatocytes (due to cytoplasmic HBsAg).
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