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Acute hepatitis Pathology: Most of the parenchymal changes which occur are essentially similar whatever the cause Hepatocytes: Show degenerative changes (swelling, cytoplasmic granularity, vacuolation) Undergo necrosis (becoming shrunken, eosinophilic Councilman bodies) Are rapidly removed The distribution of these changes varies somewhat with the aetiological agent, but necrosis is usually maximal in zone 3 The extent of the damage ranges from spotty or focal necrosis to massive hepatic necrosis (resulting in fulminant hepatic failure) Common causes of acute hepatitis: Viral infections: Hepatitis A, B, (D), C and E EBV CMV Yellow-fever virus Non-viral infections: Toxoplasma gondii Leptospira icterohaemorrhagiae Drugs: Paracetamol Halothane Alcohol Poisons: Amanita phalloides (mushrooms) Aflatoxin Carbon tetrachloride Other: Pregnancy Wilson’s disease |
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