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Liver Abscess
Biliary Atresia
Cirrhosis
Cystic Fibrosis
Acute Pancreatits
Celiac Disease
Viral Hepatitis
Caused by 5 hepatotropic viruses (A,B,C,D,E)
Inner core of the virion: a.) HBcAg encodes the viral DNA
b.) HBeAg nonstructural, nonparticulate soluble Ag that
SERVES as a marker of active viral replication and correlates
with HAV DNA levels
Chronic HBV infection HBsAg (+) > 6 mos is inversely related to age
of acquisition; related to chronic liver disease and hepatocellular
carcinoma
Hepatitis B
8 genotypes: A pandemic; B and C Asia; D Southern
Europe, E Africa; F US; G US and France; H Central
America
HB vaccine: < 19 yrs. - 5/10ug and > 19 yrs. 10/20ug at 0,1,6 mos.;
immunocompromised 40/40ug
HBIG given within 12 hrs. after birth and post vaccination testing is done
9-18 mo later (importance!) ; within 24 hrs. after blood exposure; within 14
days after sexual exposure; dose: 0.5 uL NB and 0.06uL/kg for all
Universal vaccination - >95% sero(+) after 2nd dose; 3rd dose booster;
long term immunity; 4th dose immunocompromised and infants < 2kg; 1st
dose birth but can be delayed if mother is HBsAg (-); preterm and HBsAg
(-) mother delayed 1 month of age or until hospital discharge; middle
school entry
Hepatitis B
Prognosis: outcome after acute HBV infection is
favorable despite risk of ALF
Treatment: supportive
Prevention: no vaccine
Hepatitis E
HEV not isolated but is cloned; RNA virus (nonenveloped
sphere shape with spikes)
Cytopathic virus
Unknown IP
Approach to Acute and
Chronic Hepatitis
Prevention
Liver transplantation
Biliary Atresia
Extrahepatic biliary atresia (EHBA)
Progressive inflammatory process that causes both intra- and
extrahepatic bile duct fibrosis, resulting to obstructed bile
flow; unknown cause fetal/embryonic and postnatal
(immune-mediated mechanism)
F>M; prematures
Untreated leads to cirrhosis, liver failure and death in 1st 2
yrs of life
cholestasis accumulation of compounds that cannot be
excreted resulting to injury to the liver
Biliary Atresia
Clinical manifestation:
5. Splenomegaly later
7. Pruritus
Abdominal UTZ
Biliary Atresia
Therapeutic management:
2. liver transplantation
Genotyping
Cystic Fibrosis
Pathogenesis:
2. paranasal sinuses