A highly contagious liver infection caused by the hepatitis A virus.Hepatitis A is preventable by vaccine. It spreads from contaminated food or water or contact with someone who is infected.
• Anorexia, nausea, vomiting influenza like syndrome.
• Fever, soft enlarged tender liver, jaundice.
• Abnormal liver function tests with elevation of
SGOT, SGPT and LDH.
• Liver biopsy is characteristic.
Investigation:- HBsAg ,LFT ,USG ABDOMEN AND PELVIS,CBC
-Bed rest at the initial stage of the disease with gra- dual return to normal activity in convalescence.
-Plenty of oral Glucose or IV Glucose 10 per cent if oral intake is hampered due to nausea/vomiting.
-A palatable diet with less fat. If patient shows any
signs of impending coma, protein should be
-Plenty of vitamin B-Complex and vitamin ‘K’.
-Liv-52 can be given empirically at the dose of 2 tab tds for 1 to 2 months.
-If jaundice is progressive, Corticotropin or Prednisolone. Prednisolone is given for 20 days at the dose of 2 tab (5 mg tab) tds for 5 days, 1 tab tds × 5 days, 1 tab bd × 5 days and 1 tab od × 5 days.
-Phenobarbitone if restlessness occurs.
-1 per cent Phenol with Calamine lotion or Cholestyramine 4 gm daily to reduce itching. Neomycin/Paramomycin only when precoma occurs. Serum hepatitis is transmitted by infected blood or blood products. Its incubation period is long (6 weeks to 6 months) and its onset is more insidious. The clinical picture is similar to that of infectious hepatitis. The blood of the patient is positive for Australia antigen.
Hepatitis A—Human normal immunoglobulin 0.002 ml/kg IM soon after exposure.
Hepatitis B—Vaccine Engerix B given IM in deltoid muscle. Same dose for all ages in 3 doses. Second dose 1 month after first dose and third dose 6 months after 1st dose.
DRUG TO AVOID IN LIVER DEMAGE:-
-ACE inhibitors like Enalapri