- Viral hepatitis
. . . [Full text of this article]
Postgraduate Medical Journal 2003;79:548-549; doi:10.1136/pmj.79.935.548
© 2003 BMJ Publishing Group Ltd and The Fellowship of Postgraduate Medicine.
Postgraduate Medical Journal 2003;79:548-549
© 2003 Fellowship of Postgraduate Medicine
© 2003 Fellowship of Postgraduate Medicine
SELF ASSESSMENT ANSWER
Deep jaundice in an adolescent
| The first 150 words of the full text of this article appear below. |
Q1: What is the main differential diagnosis of this patient’s initial syndrome?
In this young girl a syndrome of fever, lymphadenopathy, and hepatosplenomegaly were accompanied by intrahepatic cholestasis with high bilirubin and acute hepatocellular damage.
The differential diagnosis initially includes any cause of acute hepatitis (box 1
) and/or cholestasis (box 2). The patient was not pregnant, she was not alcoholic, took no medication, and had no history of chronic disease. Serological testing excluded acute viral hepatitis A, B, and C, which may be associated with icterus, low grade fever, lymphadenopathy, and hepatosplenomegaly. Autoimmune hepatitis may present with the same signs and symptoms, although acute icteric hepatitis as a presenting symptom is rather unusual. An important step during differential diagnosis is to exclude Wilson’s disease, which may be present in young adolescents, but acute hepatitis with cholestasis is also unusual. Moreover clinical and laboratory testing failed to diagnose Wilson’s disease in our patient.
Box 1: Differential diagnosis of acute hepatocellular damage
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