Acute Hepatitis of any etiology (from benign Hep A to imminently fatal mushroom poisoning) begins with subtle anorexia, nausea, malaise, & upper abdominal pain/discomfort.Signs on exam may include:
- Tenderness to gentle punch-percussion of the liver
- Jaundice (in acute viral hepatitis, usually occurs as other symptoms begin to subside)
Diagnose: Elevated LFTs (transaminases ALT & AST)Identifying the etiology — Start with antibody tests:
- Hep A, IgM [may order Total Hep A, fractionate IgM & IgG if positive)
- Hep B core Antibody, IgM fraction
- Hep B surface Antibody (if positive, pt. already immune)
- Hep B surface Antigen (HBsAg) = if positive, some type of Hep B
- Hep C Antibody (seroconverts at 8-12 weeks of illness; if positive, acute Sx are something else).
- Monospot or Epstein-Barr Antibody IgM.
- Hep C RNA by PCR (for acute Hep C; may be expensive).
See posting Acute Hepatitis.