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Cholestatic hepatitis what. Cholestatic acute hepatitis

Cholestatic hepatitis is a liver disease that has a diffuse character. It progresses due to inflammatory processes along medium-sized bile ducts, and also due to the accumulation of bile in the liver parenchyma.

Depending on the characteristics and stage of development of the disease, the symptoms may vary. But basically they point to signs of illness characteristic of congestion. Among the most frequent, the following symptoms are noted:

Temperature rise;
Pain on the right side;
Rashes or skin itching;
Staining of the skin, mucous membranes in yellow;
Pain after eating.

Itching

With cholestatic hepatitis, it is almost impossible to relieve itching with the help of drugs focused on relieving symptoms. Its nature has not been fully elucidated, but annoying skin itching significantly worsens the condition of patients. Most likely, itching occurs due to the synthesis of pruritogens (compounds in the liver). This conclusion was made due to the factor of the disappearance of pruritus in the terminal stage of liver failure.

But often the appearance of itching is associated with the fact that bile acids accumulate in organs, including the skin, thereby irritating the nerve endings of its integument. Although, there is an opinion that there is no relationship between the manifestation of itching and the level of bile acids in the blood serum. In any case, there is no evidence for this.

As for jaundice, it manifests itself a little later than skin itching and develops rapidly in the future. In addition, there is a pronounced cholestasis syndrome, which is caused by an increased content of cholesterol, alkaline phosphatase, bilirubin, copper and bile acids in the blood.

Another symptom typical of cholestatic hepatitis is the appearance of yellow spots in the corners of the eyes - xanthoma. They can be either flat or slightly raised. Xanthomas also appear in the folds of the palms, under the mammary glands or on the back. By their presence, these yellow spots fully reflect the retention of lipids in the body. There are also tuberous xanthomas, which look like small tubercles. You can notice them on the flexion-extensor surfaces, such as large joints, buttocks and places that give in to the greatest pressure.

Steatorrhea

With cholestatic hepatitis, the process of fat absorption by the body is disrupted, steatorrhea develops, the content of bile acids in the intestinal lumen drops significantly and there is a deficiency of fat-soluble vitamins (A, D, K, E).

Steatorrhea by the nature of the manifestation is directly proportional to the severity of jaundice. In the case of long-term cholestatic hepatitis, the situation may be complicated by the formation of stones. This can provoke bacterial cholangitis, accompanied by pain in the right hypochondrium, fever and jaundice. Despite the fact that synthetic and detoxifying functions are preserved in cholestatic hepatitis, liver failure may develop after three to five years.

What causes a deficiency of fat-soluble vitamins in cholestatic hepatitis?

Lack of vitamin D provokes the development of hepatic osteodystrophy. And parallel interruptions in calcium absorption in the intestine only exacerbate the situation. Osteodystrophy is very dangerous, as it affects the bones, which further entails the development of osteoporosis.
Vitamin K deficiency is expressed by a decrease in the level of prothrombin and hemorrhagic syndrome.
Lack of vitamin E provokes cerebellar dysfunction, numbness and weakness of the leg muscles, decreased tendon reflexes and sensitivity, and retinal degeneration.
Vitamin A deficiency causes blurred vision in the dark and dry skin.

What causes cholestatic hepatitis?

The main reason for the appearance of such a disease as cholestatic hepatitis is hepatitis that has not been treated or not detected at all. Due to the fact that inflammatory processes in the liver cause stagnation of bile, it does not have the ability to completely leave the body, accumulates and thereby poisons it.

Cholestatic hepatitis is divided into two main forms, which can be distinguished using or laparoscopy.

Inactive benign persistent hepatitis.
Active aggressive progressive recurrent hepatitis.

How to diagnose a disease?

The disease is diagnosed by modern laboratory methods. However, the doctor needs to be extremely careful, since quite often cholestatic hepatitis is difficult to differentiate from Botkin's disease, especially if the latter is recurrent. Particular attention should be paid to the activity of enzymes in blood tests, with chronic hepatitis they exceed the levels that indicate Botkin's disease.

This disease can be identified for sure in several ways, such as:

Puncture;
Blood test;
Extraction analysis;
Biopsy;
Laparoscopy;

How to recover from cholestatic hepatitis?

Modern medicine gives us the opportunity to receive treatment for different types and forms of hepatitis.

You should know that in the acute course of cholestatic hepatitis, immediate hospitalization is recommended. In addition, for the treatment of cholestatic hepatitis, like any other type, drugs are strictly prescribed to help the liver cope with the load (detoxification).

The most important role in therapy is played by diet, which is also prescribed to reduce the load on the liver. Is it worth mentioning that bad habits should also be abandoned at least for the duration of treatment and during the recovery period. In addition, it must be taken into account that adherence to the daily regimen, sound healthy sleep, walks in the fresh air and protecting oneself from any stress is an essential condition for successful treatment.

To recover from cholestatic hepatitis, it is necessary to conduct a complete comprehensive examination that helps to accurately establish the diagnosis and detect pathological changes in the organ. After identifying such, it is necessary to take all measures for its treatment, because only in this case it is possible to completely get rid of cholestatic hepatitis.

If the disease is acute, then the attending physician may prescribe certain hormonal preparations, which have a fairly wide range of activities. In some cases, treatment is not possible without surgery.

deposits

If we talk about complications after cholestatic hepatitis, then this question is quite extensive. It all depends on clinical picture and on how these complications could be caused, as well as on the degree of damage to the body. So, for example, due to surgery or taking hormonal drugs during therapy, the digestive system may be disrupted.

It is also unpleasant that osteoporosis can develop after hepatitis. Therefore, in some cases, doctors recommend increasing the intake of calcium-containing foods.

Why should cholestatic hepatitis be treated?

If this disease is treated negligently and you do not turn to a specialist in time, stones will soon appear in the biliary tract. And this is fraught not only with the occurrence of inflammatory processes, painful colic, but also with the appearance of peritonitis. In addition, the disease can play a cruel joke on your heart, as cholestatic hepatitis adversely affects its work. On top of that, you can get an abscess or a fistula. So if you suddenly find symptoms of cholestatic hepatitis in yourself or your loved ones, do not hesitate - immediately consult a doctor. The specialist will examine you and, if the disease is detected, will prescribe a treatment that will help to avoid serious consequences.

Cholestatic hepatitis is an uncommon type of liver disease. Most often, such an infection is diagnosed in elderly patients.

Since the causes of hepatopathy, the mechanism of the development of the disease have not yet been thoroughly studied, the treatment of the disease is also poorly developed.

general information

Cholestatic liver disease is quite rare. But nevertheless, such a disease has its own causes, symptoms and methods of treatment. According to the international classification of the disease, microbial 10 of this pathology is K83.

The disease is characterized by liver damage of a diffuse nature due to the inflammatory process in the area of the small bile ducts, as a result of congestion of bile in the liver tissues.

A key provoking factor in the development this disease are untimely detected or incorrectly treated forms of hepatitis. When the liver is affected by such pathological processes, the normal outflow of bile is disturbed in it.

Other provoking factors in the development of this disease include: the period of bearing a child, dysfunction in the hormonal background, the use of oral contraceptives, the use of antibacterial substances, tumor-like processes in the organs of the digestive system, biliary atresia, cholelithiasis, exacerbation and severe course of other types of hepatitis, cystic fibrosis, cirrhosis, diseases of the digestive system, the negative impact of toxins, the use of drugs and anabolics, dysfunction in the endocrine system.

Stagnation of biliary secretion in the liver is caused by herpesvirus and mycoplasma during their primary lesion or during exacerbation.

Symptoms and Diagnosis

Symptoms of cholestatic hepatitis are not much different from the functional dysfunctions of the organ:

The very first sign of the appearance of pathology is itching of the skin. Its appearance is due to the penetration of bile acids into the systemic circulation.
Yellowness of the epidermis is a secondary sign of the development of the disease.
Light colored stool.
Darkening of urine.
The liver increases in diameter.
The spleen is enlarged.
Hyperthermia and other signs of intoxication of the body.

The intensity of cholestasis directly affects the severity of clinical manifestations during an exacerbation of the disease. The chronic pathological process is also characterized by the appearance of pain on the right, heaviness and discomfort from the liver.

It is possible to identify the presence of cholestatic syndrome using laboratory and instrumental diagnostic methods. For this, a study of liver enzymes, their concentration in the blood is carried out. In the presence of the disease, the concentration of AST and ALT, bilirubin increases, since the liver is damaged, secondary cholestasis develops. Laboratory studies include general and biochemical analysis blood, general analysis of urine.

The concentration of such substances as transaminase, bilirubin, cholesterol, alkaline phosphatase changes. Enzyme immunoassay and detection of polymerase chain reaction are also carried out. Instrumental research methods include:

Ultrasound examination of the liver and abdominal organs. Thanks to this study, it is possible to identify visible signs of cholestasis, to detect the development of chronic hepatitis.
Additionally, such diagnostic methods as cholecystography, cholangiography are carried out.
Magnetic resonance imaging.
CT scan.

Using these methods, you can determine the state of the liver, gallbladder and bile ducts. The hepatic duct and cells of the hepatic lobule are also examined. Additional diagnostics are prescribed, if necessary, by the attending doctor. An increase in the size of an organ is not always accompanied by pain or other unpleasant, pronounced symptoms.

Treatment

Treatment of cholestatic hepatitis is to eliminate the factors that directly contribute to the development of cholestasis. The liver must be protected from the influence of negative conditions.

At acute form disease, the patient must be treated in a hospital. To cleanse the body of toxins, it is necessary to undergo a course of detoxification therapy.

To maintain the functions of hepatocytes, specialists must prescribe vitamin substances A, E, as well as vitamins of group B.

To ensure the protection of hepatocytes, hepatoprotectors (Essentiale, Karsil, Enerliv) are prescribed by the doctor. With the help of prednisolone, it is possible to prevent the further spread of the pathological process in the tissues of the affected organ.

In parallel, a diet is prescribed, alcoholic beverages should be completely excluded from the diet. To neutralize bile stasis, drugs with ursodeoxycholic acid are prescribed.

To get rid of intense itching on the skin, biligiin or cholestyramine are used. If extrahepatic cholestasis is detected by a specialist during the diagnosis, the doctor considers the advisability of using endoscopic removal of gallstones.

Folk remedies

Cholestatic hepatitis can only be treated as prescribed by the treating doctor. No non-traditional methods should be used alone. Treat folk remedies the disease is only in the early stages, moreover, such funds can only be used as an adjuvant, and not an independent one, and only after prior consultation with the treating specialist.

It is allowed to use a decoction of oats, milk thistle, rose hips, a decoction of medicinal plants.

Prevention and prognosis

Treatment of cholestatic hepatitis is carried out only by a doctor. To prevent damage to hepatocytes, it is recommended to adjust the diet, treat concomitant diseases of the abdominal organs, endocrine and hormonal dysfunctions in time.

Be sure to undergo a preventive examination once a year to exclude the onset of the development of the pathological process.

To the extent possible, introduce moderate physical exercise, try to control your condition, deal with stress.

Video

Cholestatic hepatitis: symptoms, diagnosis, treatment.

The liver is a vital organ and is considered the most big gland in the human body. The liver is involved in the processes of digestion, acts as a chemical processing center, participates in the development of new substances, neutralizes toxic substances and is part of the endocrine system. In addition, the body takes part in the processes of metabolism, hematopoiesis, storage of vitamins and trace elements.

Hepatitis is an inflammatory process of the liver, which can have various causes and mechanisms of development. One option is cholestatic hepatitis. This is a rare pathology characterized by obstruction of the outflow of bile, as well as the accumulation of its products in the affected organ. The causes and manifestations of the disease are discussed in the article.

The mechanism of development of cholestatic hepatitis is based on a slowdown or cessation of bile synthesis, resulting from a deterioration in cell function and damage to the ducts of the biliary system. According to statistics, such a disease develops in 3-8% of all clinical cases of chronic hepatitis.

Treatment of cholestatic hepatitis is not always effective, since the main etiological factors are difficult to establish. Therapy of such patients is carried out by hepatologists, gastroenterologists and surgeons.

Possible reasons

The development of cholestatic hepatitis is provoked by stagnation of bile, which can occur at the level of liver cells or intrahepatic ducts. The main cause of the development of the disease is considered to be chronic hepatitis of viral origin. Other etiological factors of cholestatic hepatitis:

The pathology of the intrahepatic ducts is provoked by chronic calculous cholecystitis, chronic pancreatitis, and pancreatic cancer.

The development of cholestatic hepatitis is also possible against the background of bearing a child. In pregnant women, the disease is caused by the influence of female sex hormones on sensitive liver cells. A similar variant of the disease is typical for 0.5-1% of all women bearing babies.

Signs of the disease

With cholestatic hepatitis, the symptoms are similar to other liver diseases. Specific signs are itching of the skin, which occurs already on early stages pathology, as well as pronounced yellowness of the skin and sclera.

This is what xanthomas on the elbows might look like

Itching occurs due to the fact that bile acids massively penetrate into the bloodstream and are carried throughout the body. The same factor causes the appearance of yellow spots under the skin, near the eyes, as well as xanthomas (soft, flat, convex papules of a yellow hue). Xanthomas are formed in those places of the human body that give in to the greatest pressure (buttocks, large joints).

Patients with cholestatic hepatitis complain of hyperthermia, discomfort, pain in the right hypochondrium, which increase after food enters the body.

Another symptom of cholestatic hepatitis is steatorrhea. Fecal masses become oily due to impaired fat metabolism. In addition, their color changes (becomes lighter).

Hypovitaminosis

Most patients suffer from hypovitaminosis A, D, E, K, which occurs as a result of violations of bile acids in the lumen of the intestinal tract.

Lack of retinol (A) - characterized by a decrease in efficiency, resistance to viral diseases, early aging of the skin, "night blindness" (violation of visual acuity at dusk).
Lack of calciferol (D) - manifested by pain in the joints, muscle cramps, weight loss, weakness, signs of rickets.
Lack of tocopherol (E) - accompanied by muscle weakness, decreased vision, irritability, fatigue, skin aging.
Deficiency of phylloquinone (K) - characterized by frequent bleeding, hematoma formation, low blood prothrombin.

Diagnosis of pathology

The specialist examines the patient, palpates the organs of the anterior abdominal wall. Be sure to collect an anamnesis of life and disease. Instrumental and laboratory research methods play an important role in the diagnosis of cholestatic hepatitis. The main analysis is blood biochemistry. In the results of the study, the doctor may detect an increase in bilirubin, ALT, AST, alkaline phosphatase and cholesterol.

If necessary, the level of various fractions of fats, bile acids in the blood is assessed. In order to confirm the viral origin of the disease, the specialist prescribes serological research methods, as well as PCR.

Confirm intrahepatic bile stasis can be based on the determination of antibodies to mitochondria. Diagnosis is performed in conjunction with the clarification of the level of transaminases and alkaline phosphatase.

Instrumental methods for the study of hepatitis:

ultrasound diagnostics of the liver, gallbladder;
cholecystography - X-ray examination of the state of the gallbladder using a contrast agent;
retrograde cholangiopancreatography - the process of introducing an endoscope with further filling of the bile and pancreatic ducts with a contrast agent, as well as subsequent X-ray radiation;
transcutaneous transhepatic cholangiography - the use of an iodine-containing contrast agent, filling the bile ducts with it and further radiography (invasive method);
MRI, CT;
liver biopsy - allows you to determine the anatomical changes in liver cells.

Features of treatment

Chronic cholestatic hepatitis requires the elimination of the main causes that led to the stagnation of bile. If medications have become etiological factors, their use should be abandoned. Hepatologists recommend patients to correct the diet, go to table number 5. The principles of diet therapy are based on the rejection of alcoholic beverages, fatty, fried, smoked foods. This will reduce the load on the liver.

A sufficient amount of water should enter the body (up to 2 liters per day), salt - up to 8 g. The level of carbohydrates and lipids should correspond to the age and body weight of the patient, and the amount of protein substances should be reduced to 80-90 g.

You need to eat often, but in small portions. The recommended daily calorie intake is 2200-2500 kcal.

Specialists prescribe the intake of tocopherol, retinol, calciferol, phylloquinone in order to restore their level in the body to optimal levels. Hepatoprotectors will help support the work of liver cells. Their action is also aimed at eliminating the adverse effects of toxic and poisonous substances on the gland. Representatives of the group of medicines - Gepabene, Karsil, Essentiale.

Intrahepatic blood stasis, manifested by a significant inflammatory process and bright skin symptoms, requires the appointment of adrenal hormones (Prednisolone). Cholestyramine will neutralize bile acids, a large amount of which causes jaundice and severe itching skin covers. To improve the outflow of bile, preparations based on ursodeoxycholic acid are used.

Surgical intervention (eg, cholecystectomy, pancreatic resection, endoscopic removal of gallstones) may be required to eliminate the etiological factors of extrahepatic congestion.

Preventive measures

Prevention of cholestatic hepatitis consists in the following points:

refusal to abuse alcohol;
prevention of the use of hepatotoxic substances;
timely treatment of liver diseases;
compliance with the rules rational nutrition, healthy lifestyle;
annual clinical examination for healthy people, periodic examinations for patients with liver pathology.

Proper treatment, adherence to the advice of qualified specialists and the elimination of the main causes of the disease are the leading factors due to which a favorable outcome can be achieved in the development of cholestatic hepatitis.

In various diseases of the biliary organs, certain syndromes of liver damage are manifested. When analyzing data from a biochemical study, four main types of pathologies are distinguished. Each of them determines the characteristic changes in the organ - both functional and morphological.

The manifestations of the syndromes differ, but in some cases they may be similar. This makes it difficult to determine various diseases liver. Only a doctor can make a diagnosis. The features of each syndrome and their manifestations should be considered.

Laboratory syndromes in liver diseases

Liver disease can be accompanied by a number of clinical manifestations. Their knowledge helps to diagnose a certain pathology in a timely manner. As a result, the patient will receive adequate therapy.

With various laboratory syndromes in liver diseases, the specific functions of the organ are violated. In some diseases, cells are damaged, in others, the outflow of bile is reduced. For this reason, liver diseases are diagnosed in a syndromic manner.

Often, clinical tests help clarify the nature of the detected liver damage. The main disorders are grouped into laboratory syndromes. In this case, indicator tests are taken into account.

If there is a suspicion of a specific disease, take into account the main biochemical syndromes that are characteristic of a particular disease. It is based on a special program of examination of patients.

Types of syndromes

It is worth considering several types of major syndromes in liver diseases. Each of them indicates a specific pathology.

There are such types of syndromes:

Cytolytic - violation of hepatocyte membranes (up to 80% of the mass of the liver).
Damage to the liver by toxins.
Cholestasis is a lack of bile production.
Inflammatory liver syndrome - impaired functioning of the liver.
Hepatocellular insufficiency.

Each of these conditions speaks of specific disorders in the liver. They are identified through laboratory tests. The main clinical signs in certain syndromes differ.

cytolytic

The cytolytic syndrome shows that the membranes of the hepatocytes (the main cells of the liver) are broken. This reaction of the body to the defeat is due to the death of tissues. As a result, the constituent elements of the cells enter the blood. There are 2 stages of the syndrome:

necrobiosis;
necrobiotic.

In the first stage, organ damage is reversible. Only morphological disturbances are observed.

If the syndrome is not complicated, mitochondrial structures are only slightly damaged. In advanced cases, liver damage with destruction of organ cells is possible. The risk of developing a tumor of the organ is high.

Laboratory syndromes in chronic hepatitis include cytolytic, liver failure, inflammation of the liver and cholestasis.

Holemia

Cholemia syndrome is a consequence of self-poisoning. It can develop with jaundice. As a result of the tests, the accumulation of bile components in the blood is revealed. The liver abruptly ceases to perform the function of detoxification.

This hepatic syndrome is very similar to cholestasis. The main manifestations include severe jaundice. The size of the liver is rapidly reduced due to tissue necrosis. Perhaps the development of nervous disorders. Hallucinations may occur. Other consequences:

cholemic bleeding - manifested with a deterioration in blood clotting;
hepatic coma;
hemorrhagic diathesis - an increased tendency of the body to bleed.

Blood can come from the gums and nose. Patients often fall into depression. Sleep is disturbed, the skin begins to itch. The diagnosis can only be made after a blood test.

cholestasis

Cholestasis is pathological condition liver that does not produce enough bile. This is due to two reasons - either the liver cells cease to perform their function, or the flow of bile through the ducts stops.

Important! There are two types of cholestasis - intrahepatic and extrahepatic.

In the first case, the bile ducts are affected and the biliary function of hepatocytes is disturbed. At the same time, bile components accumulate in hepatocytes. The syndrome of extrahepatic cholestasis occurs when it is impossible to drain bile through the common and hepatic ducts.

This syndrome occurs with biliary hypertension. It is associated with the impossibility of conducting bile along the pathways of removal. As a result, the interlobular ducts expand.

As clinical signs This hepatic syndrome is distinguished by itching, jaundice, dark urine, discoloration of feces, and pigmentation of the skin.

Inflammation in the liver

When diagnosing an inflammatory syndrome, we can talk about the activity of the pathology in the biliary organ. Signs of the disease include:

fever;
vosculitis - a group of diseases that characterize inflammation of blood vessels;
arthralgia - pain in the joints;
jaundice;
enlargement of the spleen.

An inflammatory syndrome occurs as a result of immune inflammation in the liver.

The list of causes for the development of pathology includes liver diseases, occurring in both acute and chronic forms.

Jaundice

This disease is not independent. Symptoms include yellowing of the skin and sclera. Such signs are manifested in many pathological processes in the liver. The main reason for this state of the body is the accumulation of a special substance bilirubin. It appears after the breakdown of red blood cells.

Adults with the development of this pathology may feel severe itching. The stool becomes grayish. The patient loses his appetite and feels severe pain in the right hypochondrium.

Itching with jaundice is an important indicator of the development of the disease. The intensity of sensation depends on the type of pathology. With obstructive jaundice, the most severe itching appears. Often, the feeling of scabies becomes unbearable, which leads to insomnia and exhaustion of the nervous system.

With hepatic jaundice, the skin does not itch as much. There is a feeling because the nerve endings of the skin are irritated as a result of the penetration of bile acids into the blood.

Consequences of jaundice:

intoxication of the body with bilirubin;
brain damage, manifested in hearing impairment, paralysis and convulsive states;
diarrhea and severe swelling.

Jaundice is a serious pathology that must be treated at the first manifestations.

portal hypertension

A syndrome develops when it is impossible to pass blood through the liver, which is sent to it through the splenic and portal veins. In this case, edema of the liver or cirrhosis develops. The portal vein is compressed by the tumor, the lymph nodes are enlarged.

The following symptoms appear:

bloating;
rumbling;
loss of appetite;
nausea;
pain in the umbilical region.

In the veins of the abdominal cavity, the pressure rises significantly. If blood enters the inferior vena cava, hemorrhoidal bleeding occurs. In case of varicose veins of the lower part of the esophagus, bleeding is possible.

If the umbilical veins expand, blood enters the subcutaneous vessels of the peritoneal wall. A specific pattern of veins is observed in a patient on the shoulders, forearms, and chest.

Pathology develops in accordance with certain stages. Stages of portal hypertension:

Initial. At this stage in the development of pathology, patients complain of heaviness in the right hypochondrium, general weakness, and flatulence.
Moderate. Flatulence, early satiety, nausea, feeling that the stomach is full are distinguished as manifestations at this stage. This enlarges the spleen and liver.
Expressed. There is fluid in the abdomen. All signs of portal hypertension are pronounced.
Complicated. At this stage, bleeding begins from varicose veins. Ascites develops (accumulation of fluid in the peritoneum), which is very difficult to treat.

Only a doctor can identify such stages of the syndrome, so it is important to seek help at the first signs of the disease.

Causes of portal hypertension include:

thrombosis of the portal and splenic vein;
compression of the portal vein by tumor-like formations;
increased blood flow in the portal vein.

Such reasons are identified during the examination of the patient.

hypersplenism

This syndrome is characterized by an increase in the function of the spleen. Often a painful condition occurs when there is a violation of the liver. It is in this organ that the components of the blood are destroyed. As a result of the development of the disease, the spleen breaks down a greater number of platelets, erythrocytes and leukocytes. Anemia (anemia) occurs.

An increase in the activity of the spleen function is not always associated with an increase in the size of the organ. Therefore, "hypersplenism syndrome" should not be confused with the concept of "splenomegaly syndrome".

Pathology occurs in patients with cirrhosis and hepatitis. It can also be caused by accumulation diseases (disturbance of metalolism).

Important! This syndrome is potentially lethal. This is due high risk development of sepsis (general infection of the blood).

Hepatocellular insufficiency

Hepatocellular insufficiency is characterized by impaired liver function. The symptoms of this pathology are very pronounced. The outflow of bile is significantly reduced. The liver functions insufficiently, and the cells of the organ die off. One of the most pronounced clinical manifestations is the development of jaundice. How intensely it proceeds depends on the degree of damage to the biliary tract.

When the pathology flows into the chronic stage, this symptom may not appear. There are other symptoms as well:

death of organ tissues;
fever;
discoloration of feces;
increased heart rate;
pressure drops.

There are also biochemical lesions of the liver. As the disease progresses, suffers and nervous system. This is due to a violation of the general cleansing function. The patient may be very lethargic and drowsy, or, conversely, excitable. Possible loss of consciousness, cramps in the arms and legs, nausea. The patient complains of accumulation of fluid in the peritoneal region.

With the help of modern biochemical blood tests, it is possible to assess the pathological process in the liver and identify certain laboratory syndromes. They reflect the various processes occurring in the body, and allow us to judge its functions. Since the liver is actively involved in metabolism, such conditions should be treated at the first signs. This will help avoid serious consequences. If left untreated, some diseases can be fatal.

Video

Cholestatic diseases of the liver.

Deciphering and features of viral load in hepatitis C

Viral hepatitis is the most severe infectious disease that can secretly proceed in the human body for a long time. Thanks to a blood test for hepatitis, timely diagnosis of this serious disease can be performed. Today, there are a large number of varieties of the presented disease, but they all affect the human liver and create a load on this organ.

How is a blood test for hepatitis A performed?
How is a blood test done for hepatitis B?
How does viral liver damage occur?
The most common symptoms of hepatitis
Diagnostic methods for inflammation of the liver
Deciphering the PCR analysis for hepatitis C

Viral hepatitis is characterized by a different etiology, so experts use separate methods for their rapid detection. The most common diseases that were caused by infectious or viral factors are periodontitis, fever, herpes, cytomegalovirus infection, rubella, and AIDS. In some cases, diseases appear due to the occurrence of a toxic factor or a specific autoimmune disease. Often people themselves worsen their state of health when they drink alcohol, drugs without a doctor's prescription, and also breathe chemical reagents without proper safety measures. These are loads due to which the human body gradually weakens and loses its protective functions.

Best practices differential diagnosis This is a blood test. Each doctor selects a method of research based on the diagnosis. To do this, it is necessary to carefully listen to the patient and analyze all the classic symptomatic manifestations.

How is a blood test for hepatitis A performed?

The presented viral form of the disease is an infectious disease that creates stress on the liver. The bacteria themselves immediately enter the intestine with contaminated food or water. Incubation period with this form of hepatitis is about one month, after which the main symptoms appear - dispersion, fever, jaundice.

In some cases, hepatitis A does not need to be treated because it goes away on its own without treatment. medicines. Such a disease is quite difficult to tolerate by young children under one year old, adults and the elderly. It is difficult for the baby's body to cope with the resulting load on the liver. During treatment, the doctor is faced with the task of removing all harmful substances from the human body, and completely cleanse the liver of a viral disease.

The following are the main indications, in identifying which a person should immediately seek qualified help:

Any clinical manifestations illness;
High levels of AsAt, as well as ALT in the biochemical blood test;
The presence of cholestasis;
After contact with a person who is sick with viral hepatitis A.

Blood is given in the morning and on an empty stomach. There are times when the collection of analysis falls on the afternoon. Then patients need to refrain from eating for eight hours. If an anti-HAV IgG titer is detected during decoding, then this indicates an acute course of the disease. Hepatitis creates a lot of stress on the liver and the body as a whole, so there is no need to postpone going to the doctor. Various viral forms have a negative impact and can develop into a chronic disease.

How is a blood test done for hepatitis B?

Hepatitis B is a severe viral disease that can be life threatening. Infection occurs in several common ways:

Viral infections enter directly into the blood;
Sexual contact with the patient;
A mother infects her child during childbirth.

Infection can occur even in a nail salon, during piercing, tattooing, as well as in medical institutions. Viral hepatitis B quickly penetrates into the bloodstream through existing lesions in the skin and mucous membranes. After a few days, a person may feel a moderate load on the liver.

Laboratory diagnosis of the presented disease is possible in two ways - this is the ELISA method and PCR diagnostics. Specialists check the blood for the presence of viral genetic material. The presented methods make it possible to determine even a small amount of the virus in the blood. You can take tests at any clinic, diagnostic center, laboratory and other medical institutions.

Such a disease can change its own genetics, and is also subject to various mutations. During the production of the necessary antibodies to specific viruses, new mutations of the pathogen can develop in human blood. In this case, the human body experiences a strong load. That's why the immune system may not always fully control the production of the desired antibody. Viral infections spread very quickly in the blood.

Infection with hepatitis C occurs through the hematogenous route. Young people and teenagers are at risk. This viral disease is diagnosed only in chronic forms, which can no longer be cured on their own. To determine hepatitis C? it is necessary to donate blood for enzyme immunoassay and polymer chain reaction. Deciphering the analysis for hepatitis C is carried out exclusively by highly qualified specialists.

How does viral liver damage occur?

After the viral particles enter the human body, they will be quickly delivered to the liver. She is subjected to heavy loads and trials, so it is best to seek help in a timely manner. Special structures on the surface provide every opportunity for selective attachment of bacteria to the walls of the liver. The next stage of infection is the insertion of genetic material into cells for further reproduction.

In some cases, patients may experience toxic liver damage and stress on it. This body performs a large number of main functions. First of all, it is the deactivation and elimination of toxins from the human body. An increased amount of harmful substances leads to damage. Cells are not able to cope with heavy loads and perform metabolic processes, so organic substances in the form of fat are gradually deposited in the liver.

Such a negative impact interferes with the normal functioning of liver cells, therefore, after a while, the patient experiences a partial loss of the functional abilities of the synthesis of protein molecules, transformation and dispatch of proteins.

The most common symptoms of hepatitis

When infected with hepatitis, a person may experience the following symptoms. After that, you should immediately seek qualified help.

All of the above symptoms are common to absolutely all known forms of hepatitis. But each individual species has its own distinctive features.

Diagnostic methods for inflammation of the liver

Doctors use ultrasound and laboratory tests to detect hepatitis. Also, the most common and effective way to detect the virus is quantitative analysis.

There are several signs of hepatitis:

Elevated transaminase levels. Specialists determine the enzymes of a nonspecific inflammatory response. They are released into the blood vessels during the body's inflammatory responses. The current state of the transaminase level gives a complete picture of the volume of affected tissues and the load on the body.
Elevated levels of bilirubin. To date, this indicator is a specific sign for hepatitis. Everyone knows that bilirubin is excreted from the liver in the form of a fatty acid. If there is an inflammatory process in the human body, then all liver tissues do not work properly.

Deciphering the PCR analysis for hepatitis C

To determine the presence of hepatitis C viruses in the blood and make the most accurate diagnosis, doctors widely use the polymerase chain reaction method. The presented study provides all the possibilities for the rapid detection of a small amount of virus in the blood.

At the same time, such analyzes show high accuracy and are the most effective. The study of PCR and a quantitative method helps to determine the presence of hepatitis C even in the early stages, five days after infection. At this time, antibodies have not yet appeared. There are several types of PCR analysis:

A quantitative analysis for hepatitis C is carried out in the following cases:

When the text showed a positive result, since the hepatitis C virus is present in the RNA serum.
In order to accurately and accurately determine effective treatment for the patient.
Appointment of effective tactics of treatment of the patient.

If a person does not have this disease, then RNA viruses, antibodies and antigens to them will be completely absent in the decoding. When these substances are present in the blood, this indicates the presence of hepatitis C in a chronic or acute form. In some cases, lab technicians find RNA viruses during recovery. The presence of HCV RNA in a quantitative analysis indicates the presence of the virus in the blood.

If the wrong technique for conducting the study was used during blood sampling, the conditions for transportation and sampling of the analysis were violated, then the results may be false.

When the decoding of a quantitative analysis for the determination of hepatitis C gave a positive result, it is urgent to seek help from an infectious disease specialist, as well as a gastroenterologist. He will conduct a thorough examination and determine further diagnosis and treatment.

- This is a disease in the development of which the difficulty in the flow of bile, as well as the accumulation of its constituent components in the liver, is of key importance. Clinically, the disease is manifested by itching, discomfort in the area of the right hypochondrium, intense jaundice, dyspepsia, liver enlargement and the appearance of xanthelasmas on the skin. In diagnosis, general clinical and biochemical blood tests with the determination of liver tests, ultrasound of the liver and gallbladder, sonography of the pancreas, and MRI of the abdominal organs are of primary importance. The therapy is aimed at improving the outflow of bile and normalizing the function of the organ.

General information

Causes of cholestatic hepatitis

This pathology may be due to intrahepatic or extrahepatic stagnation of bile. In the first case, a violation of the outflow of bile is possible both at the level of liver cells and at the level of intrahepatic ducts. The cause of stagnation of bile at the level of the liver is often the transition of acute viral hepatitis B, C or other types to chronic form. Also, in some cases, damage to the liver by Ebstein-Barr viruses, herpes, cytomegalovirus, mycoplasma infection leads to intrahepatic cholestasis in some cases. The cause of cholestatic hepatitis can be the intake of various drugs, such as chlorpromazine, some diuretics, antibiotics, anabolic steroids, contraceptives. The occurrence of intrahepatic cholestasis is sometimes preceded by exposure to toxins, alcohol, poisons. Cholestatic hepatitis also develops against the background of endocrine diseases.

Extrahepatic cholestasis may be due to obstruction of large ducts. In this case, his possible reasons are blockage by a stone of the common bile duct, chronic calculous cholecystitis, chronic pancreatitis, cancer of the pancreatic head and tumors of other organs of the hepatobiliary system. Against the background of cholestasis in the liver, destruction of hepatocytes occurs with subsequent dysfunction of the organ. In some cases, it is not possible to establish the cause of the development of the disease, which is interpreted as idiopathic cholestatic hepatitis.

Symptoms of cholestatic hepatitis

Symptoms of cholestatic hepatitis are similar to those of other chronic diseases liver. Distinctive features are more pronounced jaundice and pruritus, which is often the first manifestation of the disease. Itching in this case is due to the ingestion of bile acids into the blood due to stagnation of bile in the liver. Also, in patients with a cholestatic form of hepatitis, xanthomas often occur, which look like yellow spots. In this case, the color of the feces, as a rule, becomes lighter, and the urine darkens. Palpation is determined by the increase in size and density of the liver without splenomegaly. During the period of exacerbation, an increase in temperature and mild symptoms of intoxication are possible. The severity of the clinical picture depends on the severity of cholestasis.

Diagnosis of cholestatic hepatitis

Laboratory and instrumental research methods play an important role in the diagnosis of the disease. Of the laboratory methods, the biochemical blood test is considered the main one for the diagnosis of cholestasis. In a biochemical study, there is an increase in the level of bilirubin due to the direct fraction, an increase in the level of transaminases, alkaline phosphatase (more than 5 times), gamma-glutamine transferase and cholesterol. It is also possible to define increased amount in the blood of phospholipids, B-lipoproteins and bile acids. To confirm the viral etiology of the disease, a study of specific markers by ELISA and PCR is carried out. A characteristic serological marker of intrahepatic cholestasis is the determination of antimitochondrial antibodies.

Of the instrumental methods, an ultrasound scan of the liver and gallbladder is mandatory. At ultrasound examination signs of chronic hepatitis are revealed. Ultrasound of the biliary tract, gallbladder and pancreas can confirm or exclude extrahepatic cholestasis. If there are difficulties in diagnosing cholestasis, retrograde cholangiopancreatography, percutaneous transhepatic cholangiography or cholecystography are performed, which can detect stones in biliary tract in cases where they are not visible on ultrasound. Modern non-invasive methods for identifying the causes of cholestatic hepatitis are MR-pancreatocholangiography and MRI of the hepatobiliary zone. To study morphological changes, a needle biopsy of the liver can be performed, although it does not play a decisive role in the diagnosis of cholestasis.

Treatment of cholestatic hepatitis

Treatment of chronic hepatitis with cholestatic syndrome should be based on the elimination of the cause that led to cholestasis. If the cause of the disease is exposure to toxic factors or medications, then it is necessary to stop their entry into the body. All patients are advised to adhere to diet number 5, which provides for the exclusion of spicy, fatty and fried foods. Be sure to minimize the use of alcohol, which negatively affects liver cells. A nutritious diet with enough protein is also recommended. At any stage of the disease, it is desirable to take fat-soluble vitamins A, E, and B12. To improve the function of hepatocytes, hepatoprotectors, essential phospholipids and lipoic acid can be prescribed.

In the presence of intrahepatic cholestasis with a high activity of the inflammatory process, the appointment of small doses of prednisolone is indicated to reduce the severity pathological changes. If the patient is concerned about severe itching, it is necessary to use drugs to neutralize bile acids, such as cholestyramine or lignin. by the most effective tool for the treatment of intrahepatic cholestasis, ursodeoxycholic acid is considered, which improves the outflow of bile. The drug is recommended for all patients with cholestatic hepatitis. If hepatitis is caused by extrahepatic cholestasis, it is necessary to eliminate its cause. For this, various surgical methods are used, such as laparoscopic or open cholecystectomy, resection of the head of the pancreas, extraction of bile duct calculi with RPCH, endoscopic balloon dilatation of the sphincter of Oddi, and so on.

Prevention of the disease is reduced to stopping the intake of alcohol and other hepatotoxic substances, as well as the timely treatment of liver pathology. At proper treatment and elimination of the cause of cholestasis, the prognosis for cholestatic hepatitis is generally favorable.