Fever elevated liver enzymes: Difference between revisions

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{{CMG}} ; {{AE}} {{MIR}}
{{CMG}} ; {{AE}} {{MIR}}
Conditions that can cause fever and elevated liver enzymes are presented in the table below, ordered based on their prevalence:
Conditions that can cause fever and elevated liver enzymes are presented in the table below, ordered based on their prevalence:
<ref name="pmid17151052">{{cite journal |vauthors=Gilson R, Brook MG |title=Hepatitis A, B, and C |journal=Sex Transm Infect |volume=82 Suppl 4 |issue= |pages=iv35–9 |year=2006 |pmid=17151052 |pmc=2563900 |doi=10.1136/sti.2006.023218 |url=}}</ref><ref name="pmid7686702">{{cite journal |vauthors=Heintges T, Niederau C |title=Differentiation between autoimmune hepatitis and hepatitis C virus related liver disease |journal=Z Gastroenterol |volume=31 |issue=5 |pages=285–8 |year=1993 |pmid=7686702 |doi= |url=}}</ref><ref name="pmid25852281">{{cite journal |vauthors=Park JW, Kwak KM, Kim SE, Jang MK, Kim DJ, Lee MS, Kim HS, Park CK |title=Differentiation of acute and chronic hepatitis B in IgM anti-HBc positive patients |journal=World J. Gastroenterol. |volume=21 |issue=13 |pages=3953–9 |year=2015 |pmid=25852281 |pmc=4385543 |doi=10.3748/wjg.v21.i13.3953 |url=}}</ref>
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Revision as of 20:00, 11 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2] Conditions that can cause fever and elevated liver enzymes are presented in the table below, ordered based on their prevalence: [1][2][3]

Disease Clinical manifestations Laboratory findings Additional findings
Symptoms Signs Transaminitis (elevated AST and ALT) Viral markers Autoimmune markers
Nausea & vomiting Abdominal pain Arthralgia Jaundice Hepatomegaly
Acute viral hepatitis Hepatitis A +++ ++ + +++ + +++ HAV Ab ---
  • Fecal-oral transmission
  • Usually acute and self limit
  • Fever usually present
Hepatitis B +++ ++ ++ +++ + +++ HBs Ag, HBc Ab, HBe Ag ---
  • Percutaneous transmission most common
  • May cause acute hepatic failure or may become chronic
  • Fever usually present
Hepatitis C +++ ++ ++ +++ + +++ HCV Ab ---
Hepatitis E ++ ++ +/- ++ + +++ HEV Ab ---
  • Fecal-oral transmission
  • May cause fulminant disease in pregnancy
  • Fever usually present
CMV hepatitis +/- ++ - + + ++ CMV-specific immunoglobulin (Ig)M antibody --
  • Usually manifests as mononucleosis syndrome
  • fever usually present
EBV hepatitis +/- ++ - +/- + ++ Heterophile antibody test, monospot test --
  • Systemic manifestations as mononucleosis syndrome
  • Fever usually present
Autoimmune hepatitis - + +/- ++ + +++ --- ANA, ASMA, anti SLA/LP, ANCA, ALKM-1 antibodies
  • Liver biopsy may be required for diagnosis
Alcoholic hepatitis +/- + - + - AST>ALT --- ---
  • History of alcohol intake
Drug induced hepatitis +/- + - + + ++ --- ---
  • May cause either cholestatic or hepatocellular injury
  1. ↑ Gilson R, Brook MG (2006). "Hepatitis A, B, and C". Sex Transm Infect. 82 Suppl 4: iv35–9. doi:10.1136/sti.2006.023218. PMC 2563900. PMID 17151052.
  2. ↑ Heintges T, Niederau C (1993). "Differentiation between autoimmune hepatitis and hepatitis C virus related liver disease". Z Gastroenterol. 31 (5): 285–8. PMID 7686702.
  3. ↑ Park JW, Kwak KM, Kim SE, Jang MK, Kim DJ, Lee MS, Kim HS, Park CK (2015). "Differentiation of acute and chronic hepatitis B in IgM anti-HBc positive patients". World J. Gastroenterol. 21 (13): 3953–9. doi:10.3748/wjg.v21.i13.3953. PMC 4385543. PMID 25852281.
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