Acute Hepatitis Including Acute Liver Failure

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Case 1 • 52 year old Caucasian male • GP referral to surgeons with “obstructive jaundice” • US and MRCP (stones in gall bladder, spleen 13 cm) • liver biochemistry • refer to physicians (seen 2 weeks later in clinic) • ALT 1263, bilirubin 250, INR 1.1 (and stable for 2 weeks) • viral serology negative • immunology • antinuclear antibody and anti smooth muscle antibody positive • slightly elevated immunoglobulins • diagnosis: aetiology and severity? • acute autoimmune hepatitis (can be underlying chronic damage) • no evidence of liver failure (not incipient) • liver biopsy
Liver Biopsy in Acute Hepatitis Histological Approach 1. Is this acute or chronic damage? 2. How severe is the damage? 3. What is the cause?
Page 1 and 2: Acute Hepatitis Including Acute Liv
Page 3 and 4: Acute Liver Failure (ALF) FHF and L
Page 5 and 6: Acute Liver Failure Admissions Birm
Page 7 and 8: Acute Liver Injury Establishing the
Page 9 and 10: Acute Liver Injury Establishing the
Page 11: Case 1
Page 15 and 16: Case 1
Page 17 and 18: Case 1 - ductular reaction CK7 immu
Page 19 and 20: Case 1
Page 21 and 22: Case 1 (PAS-diastase)
Page 23 and 24: Acute Hepatitis Hepatocyte Prolifer
Page 25 and 26: Case 1 (HVG)
Page 27 and 28: Case 1 Diagnosis • Acute hepatiti
Page 29 and 30: Autoimmune Hepatitis - Acute Presen
Page 31 and 32: Case 1- outcome • Treatment with
Page 33: Case 2 LIVER BIOPSY
Page 39 and 40: Case 2 - outcome • Mild encephalo
Page 41 and 42: Case 2. Macroscopic Appearances Shr
Page 46 and 47: Could this be cirrhotic?
Page 51 and 52: Other Changes Seen in Areas of Pare
Page 53 and 54: Hepatectomy Specimen - Case 2 Histo
Page 55 and 56: Role of Liver Biopsy in Acute Hepat
Page 57 and 58: Acute versus Chronic Damage Severe
Page 59 and 60: Liver Cell Death in Acute Hepatitis
Page 61 and 62: Acute Hepatitis - Common Causes 1.
Page 63 and 64:
Acute Hepatitis - Aetiological Cons
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Acute Hepatitis Including Acute Liver Failure

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