• Hepatitis
  • (liver inflammation)

Strictly, hepatitis, refers to inflammation of the liver. Even though "hepatitis" sounds like a very specific diagnosis, it really can include just about condition that causes an irritated and inflamed liver.

• There is a lot of leeway in how severe that inflammation is in hepatitis, "inflamed enough" can be so inflamed that the liver can't manage to hold up its end in the body's workings
• ...or, it can mean just inflamed enough that lab tests - like the blood tests called liver function tests, come back abnormal, but the person seems to be ok.
  • When a person is sick with hepatitis there are outward signs (like jaundice) and that person is said to be "clinically ill",
  • but when a liver is so slighly inflamed that there are no outward signs, the case is said to be "sub-clinical" - that means that blood tests might show the problem but, otherwise, it's not evident.
    • If there is clinical illness, enough inflammation to make a person sick, a good doctor can tell that there is a problem just by talking to the patient (taking a history) and by performing a physical examination.
    • If the illness is subclinical, if the inflammation has not been enough to cause even mild signs of liver disease, even an excellent doctor will not know that hepatitis may be present unless he or she draws blood and receives the test results back from the lab.

There are many reasons that hepatitis can happen. Those include drug reactions, including binge drinking and alcoholism, and viral infections.

• Even so, in common usage, when it's said that "so-and-so has hepatitis", most often what's meant is some specific form of viral hepatitis, like A, B, or C; and that the inflammation is severe enough that the person is clinically ill.

Hepatitis is also part of some kinds of diseases that affect the whole body, systemic diseases like lupus and other rheumatic disorders.

One reason that subclinical hepatitis is so important is that an inflamed liver is not as able to handle another blow to its well-being as a perfectly healthy liver.

• Hypoxic Hepatitis
  • Hypoxic liver injury is defined as a massive, but transient, increase in serum transaminase levels due to an imbalance between hepatic oxygen supply and demand in the absence of other acute causes of liver damage. It typically occurs in elderly individuals with right-sided congestive heart failure and low cardiac output. Precipitating factors include arrhythmias or pulmonary edema. Symptoms include weakness, shortness of breath, and right upper quadrant pain. Less commonly, hypoxic liver injury is seen in patients with severe hypoxemia or septic shock. Characteristically, the transaminase level is elevated 20-fold but normalizes rapidly over several days. Imaging studies reveal hypoechoic or hypodense lesions that resolve completely with reversal of the initiating event. Treatment and prognosis depend on the underlying disease. [Ebert EC. Hypoxic liver injury. Mayo Clinic Proceedings. 81(9):1232-6, 2006 Sep. ]
• Non-alcoholic Steato-hepatitis (NASH)
  • [Neuschwander-Tetri BA. Nonalcoholic steatohepatitis and the metabolic syndrome. American Journal of the Medical Sciences. 330(6):326-35, 2005 Dec. ]
• Hepatitis in Auto-immune and Rheumatic Diseases

• Ebert EC. Hypoxic liver injury. [Review] [61 refs] [Journal Article. Review] Mayo Clinic Proceedings. 81(9):1232-6, 2006 Sep.
• Neuschwander-Tetri BA. Nonalcoholic steatohepatitis and the metabolic syndrome. American Journal of the Medical Sciences. 330(6):326-35, 2005 Dec.
• Reid BM. Sanyal AJ. Evaluation and management of non-alcoholic steatohepatitis. [Review] [39 refs] [Journal Article. Research Support, U.S. Gov't, P.H.S.. Review] European Journal of Gastroenterology & Hepatology. 16(11):1117-22, 2004 Nov.
• Abraham S. Begum S. Isenberg D. Hepatic manifestations of autoimmune rheumatic diseases.[see comment]. [Review] [72 refs] [Journal Article. Review] Annals of the Rheumatic Diseases. 63(2):123-9, 2004 Feb.
• Staat MA. Infectious disease issues in internationally adopted children. [Review] [10 refs] [Journal Article. Research Support, Non-U.S. Gov't. Review] Pediatric Infectious Disease Journal. 21(3):257-8, 2002 Mar.