Fever elevated liver enzymes: Difference between revisions

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__NOTOC__
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{{CMG}} ; {{AE}} {{SMP}}, {{USAMA}}, {{MIR}}
{{CMG}} ; {{AE}} {{SMP}}, {{USAMA}}, {{MIR}}
{{SK}} Fever and elevated liver enzyme, Fever and elevated LFT, Fever and elevated liver function tests, Elevated liver enzymes and fever, Elevated LFT and fever, Hyperthermia and elevated LFT, Hyperthermia and elevated liver enzymes.
== Differential diagnosis of Fever and elevated liver enzymes==
== Differential diagnosis of Fever and elevated liver enzymes==
{{SK}} Fever and elevated liver enzyme, Fever and elevated LFT, Fever and elevated liver function tests, Elevated liver enzymes and fever, Elevated LFT and fever, Hyperthermia and elevated LFT, Hyperthermia and elevated liver enzymes.
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>
<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>

Revision as of 12:33, 12 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2], Usama Talib, BSc, MD [3], Mahshid Mir, M.D. [4] Synonyms and keywords: Fever and elevated liver enzyme, Fever and elevated LFT, Fever and elevated liver function tests, Elevated liver enzymes and fever, Elevated LFT and fever, Hyperthermia and elevated LFT, Hyperthermia and elevated liver enzymes.

Differential diagnosis of Fever and elevated liver enzymes

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

References

  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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