Viral hepatitis. The alphabet game.
Differential diagnosis of viral hepatitis begins with a check for darkened urine and bile in the urine. These hallmarks of conjugated hyperbilirubinemia immediately rule out prehepatic liver disease. Next, studies are done for the elevated transaminase levels that are characteristic of hepatitis infection, and a thorough history is taken to rule out drug- and toxin-induced hepatitis that may mimic acute viral hepatitis. Elevated alkaline phosphatase is a good marker of cholestasis. Ultrasonography can clarify this diagnosis. The classic presenting symptoms of viral hepatitis are jaundice, nausea, vomiting, malaise, anorexia, and dull right upper quadrant pain. However, serologic studies are needed to detect the presence of specific viral agents.
D000208:Acute Disease; D003937:Diagnosis, Differential; D006509:Hepatitis B / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007565:Jaundice / Q000209:etiology*