Hepatitis, icteric

Icteric hepatitis is generally accompanied by dark urine, acholic (light-colored) stools, and worsening of systemic symptoms. 

Altemanthera philoxeroides (Mart.) Griseb. A. sessilis (L.) R. Brown Kong Xin Lian Zi Cao Man Ti Xian (aerial part) Saponin, coumarin, tannins, falvins.33 Treat viral infections, measles, hemorrhagic fever, toxic and icteric hepatitis. 

Hypericum attenuatum Choisy H. ascyron L. //. japonicum Thunb. //. perforatum L. sumpsonii Hance Jin Si Tao or Di Er Cao Guan Ye Lean Qiao Tian Bao Cao (St. John s wort) (whole plant) Quercetin, quercitrin, isoquercitrin, sarolactone, hypericin, usigtoercin, protohypericin, kaempferol.33,53,265,450 Antipyretic, antibacterial, detoxicant, treat acute icteric hepatitis, lower blood pressure, dysmenorrhea, gonorrhea, skin ailments. 

Swertia diluta (Turcz.) Benth. et Hook. f. S. mileensis L. Qing Ye Dan (whole plant) Oleanolic acid.33 Treat acute icteric hepatitis. 

Swertia pseudochinensis Dang Yao (whole plant) Swertiamarin, swertisin, methyl-bellidifolin, homoorentin, methyl-swertianin, isovitexin, bellidifolin, decussatin, swertifrancheside.33 Choleretic, improve hepatic function. Treat acute icteric hepatitis, chronic liver disease. 

Hypericum perforatum L. China Quercetin, quercitrin, isoquercitrin.33-53 Antipyretic, antibacterial, detoxicant effect, treat acute icteric hepatitis, lower blood pressure, dysmenorrhea, gonorrhea, skin ailments. 

In acute viral hepatitis A, there is a marked increase in IgM during the course of 6-8 weeks and a subsequent slight increase of IgG. As of the 2 week of disease, the IgM level declines faster than the slightly elevated IgG level, with normalization of IgM after 4 weeks. A persistent elevation of IgM and IgG or a marked elevation of IgG is suggestive of persistent (protracted) hepatitis. Apart from an increase of IgM, acute viral hepatitis B and C are associated with a stronger and earlier increase in IgG than in viral hepatitis A. Normalization of IgG and IgM values occurs more slowly than in hepatitis A. Normal values of IgG are mostly reached only after 6 months. There are no differences between the icteric and the anicteric form. 

Hepatitis A virns (HAV) Only a few reports on hepatitis A virus transmission have appeared (153,154). In 1992 an outbreak of icteric hepatitis A involving at least 83 patients with hemophilia A in Italy, Belginm, Ireland, and Germany was docnmented aU had been treated with a high purity factor VIII concentrate prodnced by one manufacturer (157,158) there was icterus in 93% and a diagnosis of hepatitis A was based on the presence of IgM anti-HA. The original sonrce of contamination was not definitively estabhshed, bnt it is possible that the virus did not originate from the plasma donors. 

Acute exacerbation of hepatitis is an extremely rare complication of chronic hepatitis C treatment. An exaggerated immune response to hepatitis virus was supposedly the cause of acute icteric hepatitis in two patients (SEDA-21, 372) (248). 

A 62-year-old man had taken a tea made from T. capi-tatum for 4 months when he developed anorexia, nausea, and malaise (25). He also noted dark urine and jaundice. He was admitted to hospital with acute icteric hepatitis. A liver biopsy showed bridging necrosis, inflammatory infiltration, and bile emboli. After withdrawal of the herbal tea he made a full recovery within 3 months. 

In four men aged 27, 41, 47, and 49 years, nevirapine was associated with a skin rash, malaise, and icteric hepatitis, 4-6 weeks after the start of therapy resolution occurred after withdrawal of nevirapine (13). 

Hepatic damage has rarely been reported (SEDA-1, 90). Fatal icteric hepatitis occurred in a patient taking niflumic acid and paracetamol (SEDA-13, 83). 

A healthy 14-year-old adolescent girl developed nausea, vomiting, general malaise, and weight loss. Several days later she became icteric and was admitted to hospital with acute hepatitis. Drug history revealed no alcohol use two kava products and occasional ibuprofen had been used over the preceding 4 months. 

A 45-year-old male with history of hepatitis C and now cirrhosis of the liver is bronght to the emergency center by family members for acute mental status changes. The family reports that the patient has been very disoriented and confused over the last few days and has been nauseated and vomiting blood. The family first noticed disturbances in his sleep pattern followed by alterations in his personality and mood. On examination, he is disoriented with evidence of icteric sclera. His abdomen is distended with a fluid wave appreciated. He has asterixis and hyperreflexia on neurologic exam. His urine drug screen and ethyl alcohol (EtOH) screen are both negative. A blood ammonia level was noted to be elevated, and all other tests have been normal. 

Viral Hepatitis A. During the acute icteric stage of infectious hepatitis, the mean serum alkaline phosphatase activity is approximately... 

Gullick (G27) studied 100 patients with carcinoma of the pancreas. Fifteen of 18 icteric patients had elevated serum alkaline phosphatase values, but there was no correlation between the severity of the hyperbilirubinemia and that of the hyperphosphatasemia. Among nonicteric patients, serum alkaline phosphatase elevation was usually associated with hepatic metastases (G27). The majority of patients with carcinoma of the pancreas without biliary obstruction have normal serum alkaline phosphatase activities (K32). 

For acute icteric hepatitis, add Yin Chen Hao Tang (Artemisia Capillaris Decoction), i.e., Herba Artemisiae Capillaris (Yin Chen Hao), Fructus Gardeniae Jasminoidis (Zhi Zi), and Radix et Rhizoma Rhei (Da Huang). 

Indications Replete heat and fire toxins, exuberant heat in the three burners patterns. Septicemia, dysentery, pneumonia, acute urinary tract infections, ulcers, carbuncles, furuncles, boils, acute enteritis, acute icteric hepatitis, acute cholecystitis, encephalitis, acute conjunctivitis, acute pelvic inflammation, erysipelas, cellulitis, hemoptysis, epistaxis, urticaria, pruritus, cerebral hemorrhage, hypertension, anxiety, palpitations, insomnia, neurasthenia, and hysteria... 

In case of acute icteric hepatitis, subtract Alisma and Plantago and add Herba Artemisiae Capillaris (Yin Chen). 

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