Acute hepatitis

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Etiology

Causes of acute hepatitis

  • Viral: hepatitis A, B, C*, D (in presence of B), E, infectious mononucleosis, CMV, HSV, parvovirus B19
  • Other infections, e.g., leptospirosis, secondary syphilis, brucellosis, Q fever
  • Alcoholic hepatitis
  • Toxins (predictable): acetaminophen, Amanita mushrooms, tetracycline, valproic acid
  • Toxins (idiosyncratic): INH, NSAIDs, statins, azole antifungals, halothane, ecstasy, kava
  • Vascular: right-sided CHF, shock liver, portal vein thrombosis, Budd-Chiari syndrome
  • Metabolic: Wilson’s disease, acute fatty liver of pregnancy, Reye’s syndrome
  • Autoimmune hepatitis*
  • Lymphoma or metastatic cancer*

* generally do not present acutely

Causes of cholestasis (selected)

  • Extrahepatic: choledocholithiasis, pancreatic tumor, biliary stricture, primary sclerosing cholangitis (intra- and extrahepatic)
  • Intrahepatic: primary biliary cirrhosis, autoimmune cholangitis, infiltrative disease (e.g., TB, sarcoidosis, lymphoma, amyloidosis), drugs

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Etiology

Causes of acute hepatitis

  • Viral: hepatitis A, B, C*, D (in presence of B), E, infectious mononucleosis, CMV, HSV, parvovirus B19
  • Other infections, e.g., leptospirosis, secondary syphilis, brucellosis, Q fever
  • Alcoholic hepatitis
  • Toxins (predictable): acetaminophen, Amanita mushrooms, tetracycline, valproic acid
  • Toxins (idiosyncratic): INH, NSAIDs, statins, azole antifungals, halothane, ecstasy, kava
  • Vascular: right-sided CHF, shock liver, portal vein thrombosis, Budd-Chiari syndrome
  • Metabolic: Wilson’s disease, acute fatty liver of pregnancy, Reye’s syndrome
  • Autoimmune hepatitis*
  • Lymphoma or metastatic cancer*

* generally do not present acutely

Causes of cholestasis (selected)

  • Extrahepatic: choledocholithiasis, pancreatic tumor, biliary stricture, primary sclerosing cholangitis (intra- and extrahepatic)
  • Intrahepatic: primary biliary cirrhosis, autoimmune cholangitis, infiltrative disease (e.g., TB, sarcoidosis, lymphoma, amyloidosis), drugs

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