Hepatitis b patient case study

Serum HBV DNA level was measured using fluorescein quantitative polymerase chain reaction at study entry and the last visit. Chronic hepatitis B virus HBV infection is still a worldwide health problem[ 1 ], with approximate million patients persistently infected[ 23 ]. The relative risk of HBV carriers for the development of HCC is up towhich is one of the highest relative risks known for a human malignancy[ 5 ]. Due to the high incidence of recurrence and secondary primary tumor, the survival rate of HCC after any treatment is still low[ 6 ].

Therefore, looking for the predictive factors for HCC in patients with chronic Hepatitis B will have a profound impact on the prevention and treatment of chronic HBV infection. Viral, host sex, age and genetic susceptibility and environmental factors may play interactive roles in hepatocarcinogenesis[ 7 — 12 ].

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However, it is important to study different endemic regions to verify the relationship between active HBV replication and development of HCC, because there is a geographic distribution of HBV genotypes. In particular, the data are largely lacking in mainland of China, where chronic HBV infection is highly endemic and accounts for half of the chronic hepatitis B in the world.

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In Octoberabout 18 male residents between the ages of 20 and 65 yr living in 17 townships in Qidong county, China were invited to participate in a prospective study. Each study participant provided informed written consent and a structured questionnaire on sociodemographic characteristics, habits of alcohol and tobacco consumption and family histories.

A serum specimen was collected from each participant at every interview.

hepatitis b patient case study

Wilcoxon signed ranks test has been used to compare the constancy of the viral replication at two time points. Binary unconditional logistic regression analysis was used to evaluate relative risks. Potential confounders including age, cigarette smoking, alcohol consumption and family history of chronic liver diseases were adjusted.

Hepatitis A and B Case Study

SPSS No participants had any clinical evidence of HCC at study entry. By December 31,participants died of HCC. The data were obtained from medical records and searches of computer files of death certification and cancer registry systems.

To ensure complete ascertainment, we also contacted relatives by mail to identify cases. Seventy-three patients diagnosed with HCC within the first two years of our study probably had subclinical HCC at study entry, and were therefore, excluded from the analysis, which left cases of HCC. Two hundred and seventy-six subjects with chronic Hepatitis B infection and normal ALT level at each follow-up, and free of evidence of cirrhosis or HCC, were selected as controls.

Hepatitis A and B - Case Summary

At baseline, there were no significant differences in age, cigarette smoking and alcohol consumption between HCC and control patients, while the family histories of HBV-associated chronic liver diseases were significantly different between the two groups. The analysis has been adjusted for age, cigarette smoking, alcohol consumption and family history of chronic liver diseases. Adjusted for age at enrollment continuous variablecigarette smoking, alcohol consumption and family history of chronic liver diseases.

For the 46 patients for whom the serum samples were collected both at study entry and at or after the time of HCC diagnosis, the time interval between collection of the two samples ranged from 24 to 94 mo.

Family history of liver carcinoma is one of the main risk factors for HCC, especially in the Chinese population[ 20 — 22 ]. The guidelines are supported by the findings of a meta-analysis of 26 trials of statistical significance and consistent correlations between viral load and histological grading, and biochemical and serological response[ 23 ]. Moreover, it is important to know that compared to viral loads between 5.

Chronic HBV carriers with mid-high viral loads 4. Our findings are partly consistent with studies in different areas.Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.

If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy. See our Privacy Policy and User Agreement for details. Published on Apr 24, Case study Hepatitis. SlideShare Explore Search You. Submit Search. Home Explore. Successfully reported this slideshow. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads.

You can change your ad preferences anytime. Upcoming SlideShare. Like this presentation? Why not share! Embed Size px. Start on. Show related SlideShares at end. WordPress Shortcode. Full Name Comment goes here. Are you sure you want to Yes No. Vakbrahm Sakariya. Madhuri Chaudhary. Suresh Mali. Anu Manandhar. Show More.Viral hepatitis was seen in two siblings. Jon acquired hepatitis type A in an endemic area from ingesting food or water containing contaminated human fecal matter.

Laura contracted type B hepatitis from a navel piercing from unsanitary conditions. Either the equipment was contaminated or the person s involved in the piercing procedure were carriers of the virus, or possibly both. The symptoms of the various forms of hepatitis are very similar.

They include nausea, vomiting, weight loss, jaundice and tiredness among others. The diagnosis of the disease was made by two medical doctors specializing in internal medicine.

Hepatitis B Infection with Case – Disorders of the Hepatobiliary Tract - Lecturio

One had a sub-specialty in infectious diseases. The elevated liver enzymes indicated damaged hepatocytes and subsequent diminished liver function.

Both patients showed some jaundice due to a build-up of bilirubin in the skin. Tests showed the presence of the virus because the immune system reacted to the virus's presence by forming antibodies, or by demonstrating viral particles circulating in the patient's serum. As you recall, the IgM immunoglobulin class of antibodies appear early in the course of the disease then gradually decline.

On the other hand, IgG antibodies rise later and are those responsible for lasting immunity. Treatment consisted of replacing fluids lost through dehydration from vomiting and diarrhea.

Rest and nourishment eventually restored both patients to a healthy state. In some patients, the administration of the substance alpha-interferon may improve the course of the disease, particularly with hepatitis B and C.

The prognosis for recovery from hepatitis is very good, especially in otherwise healthy individuals such as Jon and Laura. Prevention is based on avoidance of risk factors. Hepatitis B protection can be acquired through a vaccine. In most states, it is required for all healthcare professionals. Additionally, a vaccine for hepatitis type A is available. Unvaccinated individuals should exercise caution when in endemic areas by avoiding possibly contaminated food and drink from unreliable sources.

Two physicians collaborated in this case to form a diagnosis. Both had specialties in internal medicine, but one of the physicians also had a specialty in infectious disease. Nurses were responsible for treating many of the symptoms including administering medications and intravenous fluids. Medical laboratory technologists were responsible for the liver function tests as well as the diagnostic hepatitis antigen and antibody tests. Hepatitis A and B - Case Summary.While we have selected sites that we believe offer good, reliable information, we are not responsible for the content provided.

Furthermore, these links do not constitute an endorsement of these organizations or their programs by NetCE, and none should be inferred. Your certificate s of completion have been emailed to. Patient A is 19 years of age and a college sophomore who presented to her physician's office with mild jaundice.

The patient reports being in good health until a week before, at which time she began having flu-like symptoms of headache, low-grade fever, nausea, loss of appetite, and malaise. She self-treated the fever with acetaminophen. The symptoms persisted. Upon awakening this morning, she noticed that her eyes were yellow.

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She therefore contacted her physician's office. In response to her physician's questions, she indicated that her urine has been darker than usual and she has been experiencing joint pain for the last three days.

She also acknowledged that her stools have been lighter than usual. Her medical history is positive for mild exercise-induced asthma, for which she uses a prophylactic bronchodilating inhaler. She reports no surgeries. Family history is positive for cardiovascular disease father and both sets of grandparents and breast cancer mother.

Other significant history includes that she was immunized against hepatitis B at 12 years of age and she recently participated in a two-week mission trip to Central America. Although she was very cautious about the foods she ingested during the mission trip, the patient indicated that a primary recreational activity after the day's work was to swim in the lagoon near the village.

The lagoon was fed both by the stream in which the natives washed their clothes and the adjacent bay. Rainfall averaged 2—3 inches per day. Patient A returned to the United States five weeks ago.

hepatitis b patient case study

Physical examination revealed a well-developed, well-nourished female who was alert and oriented. Her temperature was Abnormal physical findings included mild icterus of sclera and skin, abdominal tenderness, hepatomegaly, and palpable spleen.

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Results of laboratory tests are indicated in Table 2. Patient A has presented with classic signs and symptoms of acute hepatitis. Based on her past history, travel, and exposure history, the most likely diagnosis is acute hepatitis A infection. The hepatic chemistry profile and serologic studies confirm this diagnosis. Exposure probably resulted from accidental ingestion of contaminated water while swimming in the lagoon.

Because acute viral hepatitis is usually a self-limited disease and Patient A is alert with no evidence of coagulopathy, she can be managed as an outpatient with close follow-up. Liver enzymes and PT should be monitored every 5 to 7 days for the first two weeks, then, if convalescence is satisfactory, at day intervals until function test results have returned to normal.

Bed rest is not indicated, but the patient should avoid strenuous activity. She should eat a well-balanced diet and abstain from alcohol for the duration of the illness. Because acetaminophen can be toxic to the liver, ibuprofen would be a better alternative for controlling fever. No other alterations in the patient's medications are necessary at this point. If nausea precludes the patient from ingesting food and fluids, IV replacement of fluids and electrolytes may be necessary.

In the event the patient develops bleeding tendencies or signs of encephalopathy, she should immediately be taken to the hospital or her physician's office. Hepatitis A virus is a reportable disease. The health department should be informed of the case immediately.Autoimmune hepatitis AIH is a rare autoimmune disorder causing chronic liver inflammation. The disorder, sometimes called lupoid hepatitis, is not well understood because its clinical presentation is highly variable.

The liver becomes inflamed due to T-cell-mediated activation of B cells that produce autoantibodies directed against liver antigens. This article details the case of a year-old female patient who was diagnosed with AIH type I almost a decade ago; her therapeutic regimen may serve as a useful model for the disorder.

An extensive interview was conducted with the patient. Herein, a timeline of her diagnosis is discussed, and her laboratory results are presented.

Guasha-induced hepatoprotection in chronic active hepatitis B: a case study

Currently, she is living a fairly healthy life despite her liver disease. Her most recent liver function test results were completely normal, which is unusual with AIH. The patient was prescribed the immunosuppressive drug azathioprine to treat her AIH shortly after diagnosis. She also began following a vegan diet with unrefined sugar along with regular sleep and exercise. Currently, the patient is taking no azathioprine due to consecutively normal liver function test results over the past few years.

Her continued health improvement could be credited to her strict vegan diet. In Maya year old woman was rushed to a local emergency room in Virginia, after coming home from college with severely jaundiced sclera.

According to the patient, her eyes had been yellow for a few days, which she attributed to allergies.

hepatitis b patient case study

She reported feeling healthy except for slight pruritus ie, intense itching on the backs of her hands. Test results revealed extremely high serum liver enzyme levels and elevated serum total and direct bilirubin levels; small quantities of bilirubin were found in her urine Table 1. Results of ultrasound imaging of her abdomen were unremarkable.

The patient was questioned extensively about her lifestyle and her sexual history. She indicated that she was not sexually active, did not have a history of drug abuse, and consumed very little alcohol. She had not recently been out of the country and denied any deviations from her normal diet. Her medical history revealed that she was a young adult woman who had been extremely healthy and active before this admission to the hospital. The patient insisted that other than the pruritus on her hands, she felt well.

She was discharged; in a few days, the jaundice disappeared. She was given a probable diagnosis of acute viral hepatitis. In Augustthe patient developed extreme joint pain. She was evaluated for rheumatoid arthritis; the results were negative. In Decemberthe pruritus on her hands returned. Blood work revealed that her liver enzymes remained extremely high but her bilirubin and albumin were within normal limits Table 2.

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hepatitis b patient case study

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