Liver and intrahepatic bile ducts-nontumor

Home Chapter Home Jobs Conferences Fellowships Books

Liver and intrahepatic bile ducts-nontumor

Viral hepatitis

Hepatitis A virus (HAV)

Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 12 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
=========================================================================

● Fecal-oral transmission via contaminated food or water
● Associated with overcrowding or poor sanitation
● Usually children (asymptomatic or symptomatic without jaundice)
● In adults, infection more severe with malaise and jaundice for 7-10 days
● Rarely causes massive hepatic necrosis and acute liver failure; fatal in < 0.5% of cases
● May cause acute cholestatic hepatitis with bile ductular proliferation, neutrophils around ducts, cholestasis, hepatocyte ballooning, pseudo-glands around bile plugs
● Does not produce chronic disease or carrier state in immunocompetent patients
● Causes 50% of hepatitis cases in US; effective vaccine available

Virology
=========================================================================

● Due to Picornavirus, 27 nm virion with single stranded RNA

Drawing of virion

Laboratory
=========================================================================

● Serum IgM anti-HAV is more reliable than immunostains

Micro description
=========================================================================

● Periportal inflammation and necrosis, ballooning degeneration, apoptosis
● Cholestasis and increased portal and periportal plasma cells are relatively specific for hepatitis A
● Acidophil bodies or cytolysis are present (collapse of reticulin network where cells have disappeared with appearance of macrophage aggregates)
● Bridging necrosis if severe hepatitis
● Also interface hepatitis (inflammatory infiltrate spills over into adjacent parenchyma to cause necrosis of periportal hepatocytes)
● Relative sparing of centrilobular hepatocytes

Micro images
=========================================================================

Portal and periportal inflammation with some ballooning degeneration

Lobular inflammation

Confluent necrosis (PAS)

Acidophil bodies and hydropic degeneration

With marked cholestasis

Differential diagnosis
=========================================================================

● Chronic hepatitis with moderate/severe activity (fibrosis present)

Additional references
=========================================================================

● Liver 1982;2:53, Am J Clin Pathol 1984;81:162

End of Liver and intrahepatic bile ducts-nontumor > Viral hepatitis > Hepatitis A virus (HAV)

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).