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Related Concept Videos

Hepatitis01:25

Hepatitis

80
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
80
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

271
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
271
Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

22
Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
22
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

399
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
399
Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

28
Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
28
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

379
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
379

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Older men with unexplained hepatitis.

Kok Haw Jonathan Lim1, Mark Howard2, Neil Jackson1

  • 1Department of Gastroenterology & Hepatology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

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This summary is machine-generated.

This case highlights acute Hepatitis E virus (HEV) infection causing severe liver decompensation in a patient with undiagnosed alcohol-related cirrhosis. Prompt diagnosis and treatment led to recovery and sustained alcohol abstinence.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Alcohol-related cirrhosis is a significant cause of liver disease.
  • Hepatitis E virus (HEV) infection can lead to acute liver failure.
  • Co-infection or superimposed HEV in cirrhosis patients presents diagnostic challenges.

Observation:

  • A 59-year-old male with heavy alcohol consumption presented with painless jaundice and hepatomegaly.
  • Initial investigations revealed elevated liver enzymes and imaging suggestive of cirrhosis.
  • HEV infection was diagnosed after presentation with severe hepatic decompensation.

Findings:

  • The patient experienced severe decompensation, including worsening jaundice, ascites, and variceal bleeding.
  • Treatment with ribavirin was initiated but discontinued upon negative HEV RNA.
  • The patient ultimately recovered after alcohol cessation.

Implications:

  • This case underscores the importance of considering HEV in patients with cirrhosis and acute liver decompensation.
  • Autochthonous HEV infection can have severe consequences, particularly in vulnerable populations.
  • Early diagnosis and management, alongside alcohol abstinence, are crucial for favorable outcomes.