Hepatitis E: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Alpha-1 antitrypsin deficiency.
  • Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.
  • Wilson’s disease (copper storage disease) – autosomal recessive inherited disease in which copper metabolism in the liver is disturbed by one or more gene mutations.

Infectious and parasitic diseases (A00-B99).

  • Other subgroups of viral hepatitis such as hepatitis A, B, C, or D.
  • Bacterial infections with the following pathogens:
    • Borrelia
    • Brucella
    • Chlamydia
    • Gonococcus
    • Leptospires
    • Mycobaterium tuberculosis
    • Rickettsiae (e.g., Coxiella burnetii)
    • Salmonella
    • Shigella
    • Treponema pallidum (syphilis/lues)
  • Helminthoses with the following worm species:
    • Ascaris (roundworms)
    • Bilharzia (schistosomiasis)
    • Liver fluke
    • Trichinae
  • Protozoal disease with the following protozoa:
    • Amoebae
    • Leishmania (leishmaniasis)
    • Plasmodia (malaria)
    • Toxoplasmosis
  • Viral infections with the following pathogens:
    • Adenoviruses
    • Coxsackie viruses
    • Cytomegalovirus (CMV) – both acute HEV infection and chronic HEV infection (CMV reactivation).
    • Epstein-Barr virus (EBV) – both acute HEV infection and chronic HEV- infection (EBV- reactivation).
    • Yellow fever virus
    • Herpes simplex virus (HSV)
    • Influenza virus
    • Mumps virus
    • Rubella virus
    • Varicella zoster virus (VZV)

Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

Musculoskeletal system and connective tissue (M00-M99).

  • Rheumatism

Medication

  • Z. E.g. paracetamol
  • S. below “Hepatotoxic drugs”

Environmental pollution – intoxications (poisonings).

  • Fungal toxins

Further

  • Alcohol
  • Graft-versus-host reaction (GVHD) – in chronic HEV infection.
  • Graft rejection – in chronic HEV- infection.