Hepatitis E - Revision history

Rossdonaldson1: /* Evaluation */

2024-02-28T20:28:43Z

Evaluation

@@ Línea 20: / Línea 20: @@
 ==Evaluation==
 [[File:Timecourse of acute hepatitis E infection.svg|thumb|Approximate time course of acute hepatitis E virus infection.]]
-*Clinically indistinguishable from other viral hepatitides, no serologic test available<ref>https://www.cdc.gov/hepatitis/hev/hevfaq.htm#c1</ref>
+===Workup===
 *[[LFTs]]
 *INR
@@ Línea 32: / Línea 31: @@
 **Hep C Ab
-{| class="wikitable"
+===Diagnosis===
-! Anti-hepatitis A, IgM
+*Clinically indistinguishable from other viral hepatitides, no serologic test available<ref>https://www.cdc.gov/hepatitis/hev/hevfaq.htm#c1</ref>
 {{Acute hepatitis panel}}

Rossdonaldson1: /* Evaluation */

2024-02-28T20:27:53Z

Evaluation

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	\| Acute or chronic hepatitis C; additional tests are required to make the determination		\| Acute or chronic hepatitis C; additional tests are required to make the determination
	\|}		\|}

			{{Acute hepatitis panel}}

	==Management==		==Management==

Rossdonaldson1: /* Evaluation */

2024-02-28T20:27:24Z

Evaluation

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	==Evaluation==		==Evaluation==
			[[File:Timecourse of acute hepatitis E infection.svg\|thumb\|Approximate time course of acute hepatitis E virus infection.]]
	*Clinically indistinguishable from other viral hepatitides, no serologic test available<ref>https://www.cdc.gov/hepatitis/hev/hevfaq.htm#c1</ref>		*Clinically indistinguishable from other viral hepatitides, no serologic test available<ref>https://www.cdc.gov/hepatitis/hev/hevfaq.htm#c1</ref>

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	\| Acute or chronic hepatitis C; additional tests are required to make the determination		\| Acute or chronic hepatitis C; additional tests are required to make the determination
	\|}		\|}


	==Management==		==Management==

Rossdonaldson1: /* Clinical Features */

2024-02-28T20:26:10Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
			[[File:Jaundice08.jpg\|thumb\|Jaundice of the skin]]
			[[File:Jaundice.jpg\|thumb\|Pediatric jaundice with icterus of sclera.]]
	*Incubation period 2-10 weeks, usually 5-6		*Incubation period 2-10 weeks, usually 5-6
	*Acute infection typically presents similar to [[hepatitis A]]		*Acute infection typically presents similar to [[hepatitis A]]

ClaireLewis at 21:08, 29 September 2019

2019-09-29T21:08:34Z

← Revisión anterior		Revisión del 21:08 29 sep 2019
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	*Acute infection typically presents similar to [[hepatitis A]]		*Acute infection typically presents similar to [[hepatitis A]]
	**Prodrome of [[nausea/vomiting]], mild [[fever]], malaise, anorexia, [[pruritus]]		**Prodrome of [[nausea/vomiting]], mild [[fever]], malaise, anorexia, [[pruritus]]
	**[[Jaundice, dark urine/pale stools, [[RUQ pain]], hepatomegaly		**[[Jaundice]], dark urine/pale stools, [[RUQ pain]], [[hepatomegaly]]
	*[[Liver failure]] rare '''except''' in pregnant women		*[[Liver failure]] rare '''except''' in pregnant women
	**Pregnant women tend to have more severe disease, higher risk of fulminant hepatitis and liver failure, increased risk of fetal loss		**Pregnant women tend to have more severe disease, higher risk of fulminant hepatitis and liver failure, increased risk of fetal loss
Línea 21:		Línea 21:
	*[[LFTs]]		*[[LFTs]]
	*INR		*INR
	**Coagulopathy correlates w/more severe liver dysfunction		**[[liver disease induced coagulopathy\|Coagulopathy]] correlates w/more severe liver dysfunction
	*Acute hepatitis panel		*Acute hepatitis panel
	**Hep A Ab IgM		**Hep A Ab IgM
Línea 71:		Línea 71:
	*Supportive		*Supportive
	**[[Antiemetics]]		**[[Antiemetics]]
	**Oral or IV hydration		**[[Oral rehydration therapy\|Oral]] or [[IVF\|IV hydration]]
	**Avoid hepatotoxic medications		**Avoid hepatotoxic medications
	*Patients with fulminant hepatic failure may be considered for liver transplant		*Patients with fulminant [[hepatic failure]] may be considered for liver transplant

	==Disposition==		==Disposition==

ClaireLewis: /* Background */

2019-08-18T14:54:54Z

Background

← Revisión anterior		Revisión del 14:54 18 ago 2019
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	*Nonenveloped, RNA virus		*Nonenveloped, RNA virus
	*Fecal-oral transmission		*Fecal-oral transmission
			*Common in Southeast Asia, but different genotypes found globally across Asia, Africa, Latin America<ref>Chaudhry SA et al. Hepatitis E infection during pregnancy. Can Fam Physician. 2015 Jul; 61(7): 607–608.</ref>

	==Clinical Features==		==Clinical Features==

ClaireLewis: Created page with "==Background== Nonenveloped, RNA virus Fecal-oral transmission ==Clinical Features== Incubation period 2-10 weeks, usually 5-6 Acute infection typically presents similar..."

2019-08-18T14:49:15Z

Created page with "==Background== *Nonenveloped, RNA virus *Fecal-oral transmission ==Clinical Features== *Incubation period 2-10 weeks, usually 5-6 *Acute infection typically presents similar..."

Página nueva

==Background==
*Nonenveloped, RNA virus
*Fecal-oral transmission

==Clinical Features==
*Incubation period 2-10 weeks, usually 5-6
*Acute infection typically presents similar to [[hepatitis A]]
**Prodrome of [[nausea/vomiting]], mild [[fever]], malaise, anorexia, [[pruritus]]
**[[Jaundice, dark urine/pale stools, [[RUQ pain]], hepatomegaly
*[[Liver failure]] rare '''except''' in pregnant women
**Pregnant women tend to have more severe disease, higher risk of fulminant hepatitis and liver failure, increased risk of fetal loss
**Mortality of HEV infection in 3rd trimester: 20-25%<ref>WHO fact sheet https://www.who.int/news-room/fact-sheets/detail/hepatitis-e</ref>

==Differential Diagnosis==
{{Acute hepatitis causes}}

==Evaluation==
*Clinically indistinguishable from other viral hepatitides, no serologic test available<ref>https://www.cdc.gov/hepatitis/hev/hevfaq.htm#c1</ref>

*[[LFTs]]
*INR
**Coagulopathy correlates w/more severe liver dysfunction
*Acute hepatitis panel
**Hep A Ab IgM
**Hep B cAb IgM
**Hep B sAg
**Hep B sAb
**Hep C Ab

{| class="wikitable"
! Anti-hepatitis A, IgM
! Hepatitis B surface antigen
! Anti-hepatitis B core, IgM
! Anti-hepatitis C
! Interpretation
|-
| Positive
| Negative
| Negative
| Negative
| Acute hepatitis A
|-
| Negative
| Positive
| Positive
| Negative
| Acute hepatitis B
|-
| Negative
| Positive
| Negative
| Negative
| Chronic hepatitis B infection
|-
| Negative
| Negative
| Positive
| Negative
| Acute hepatitis B; quantity of hepatitis B surface antigen is too low to detect
|-
| Negative
| Negative
| Negative
| Positive
| Acute or chronic hepatitis C; additional tests are required to make the determination
|}

==Management==
*Supportive
**[[Antiemetics]]
**Oral or IV hydration
**Avoid hepatotoxic medications
*Patients with fulminant hepatic failure may be considered for liver transplant

==Disposition==
*Typically discharge, admit if:
**Pregnant
**INR >2
**Unable to tolerate PO
**Intractable pain
**Bilirubin >30
**[[Hypoglycemia]]
**Significant comorbidity/immunocompromised

==See Also==
*[[Viral hepatitis]]

==External Links==

==References==
<references/>
[[Category:GI]] [[Category:ID]]

Hepatitis E - Revision history

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Clinical Features */

ClaireLewis at 21:08, 29 September 2019

ClaireLewis: /* Background */

ClaireLewis: Created page with "==Background== *Nonenveloped, RNA virus *Fecal-oral transmission ==Clinical Features== *Incubation period 2-10 weeks, usually 5-6 *Acute infection typically presents similar..."

ClaireLewis: Created page with "==Background== Nonenveloped, RNA virus Fecal-oral transmission ==Clinical Features== Incubation period 2-10 weeks, usually 5-6 Acute infection typically presents similar..."