some non-hepatotropic viruses can sometimes cause acute hepatitis.
aids greatly increase the variety of original rare viral hepatitis, and is often fatal.
with large doses of immunosuppressive agents in patients, such as organ transplantation, and easy experience for many viral hepatitis occurred.
non-hepatotropic virus also damages the liver and other organs; occasionally mainly hepatitis, and viral hepatitis is difficult to distinguish. may have jaundice and elevated serum transaminases, often less. changes in liver histology often non-specific: acinar focal necrosis, fatty change, liver sinusoids and periportal mononuclear cell infiltration, alveolar structural integrity.
one single infectious mononucleosis b>
infectious mononuclear cell histiocytosis (infectious mononucleods) Ⅳ by human herpes virus (epstein-barr virus, ebv)-induced systemic response of mononuclear phagocytes. more common in young people.
fever, angina, skin rash, lymphadenopathy, splenomegaly. about half of patients have mild jaundice. normal or elevated white blood cell count in peripheral blood, atypical lymphocytes accounting for 10% -50%. significantly increased serum alt and more, but less than viral hepatitis. igm anti-ebv is specific serum markers (table).
two, cytomegalovirus-induced hepatitis b>
cytomegalovirus (cytomegalovirus, cmv) in the neonatal period often latent infection, infants can cause fatal pneumonia.
clinical manifestations: b> adult infection may have very different clinical manifestations: similar to a single infectious mononucleosis, but often without angina and neck lymph nodes. fever is a symptom of more significant and sustainable to jaundice after the rebate. jaundice continues for 2-3 weeks, or even up to 3 months. alt and alp increased, gastrointestinal symptoms and elevated serum transaminases and viral hepatitis are not clear. blood lymphocytes are not typical. occasionally fatal chunk of liver cell necrosis; sometimes cause granulomatous hepatitis. unknown fever may be associated with long-term, occasional bile stasis. cmv can cause post-transfusion hepatitis; in immunosuppressed patients may lead to disseminated disease, hepatitis is a part of the disease.
chronic hbv co-infection of cmv disease increased most patients, disease activity can, or even active cirrhosis.
to the virus isolated from urine or saliva, or pcr detection of viral nucleic acid. serum igm anti-cmv positive.
see the acinar cells of liver tissue and polymorphonuclear cells focal accumulation, liver cell nuclei within the cmv inclusion bodies.
transplant complications: b> in renal transplant and liver transplant patients see a lot of cytomegalovirus hepatitis, patients treated with lymphocyte antibodies infection increases. infections from blood or a donor, except for cmv antibody positive, pi donor can prevent most infections. cmv hepatitis is liver the most common cause of transplant rejection.
acute hepatitis b and eb virus and cytomegalovirus hepatitis identify