What other forms of hepatitis are there besides A, B, C, D, E?
The causes of hepatitis discussed so far in this article are not the only triggers. In addition to the directly infectious hepatitis, caused by hepatitis viruses A, B, C, D and E, so-called accompanying hepatitis (accompanying liver inflammation) can also occur. These can then also be caused by viruses, but also by parasites or bacteria.
Parasitic pathogens that can cause hepatitis are for example the malaria pathogens, plasmodia. As bacterial pathogens of an accompanying hepatitis would be for example Salmonella. Beside these mentioned causes there are other forms of hepatitis, like a toxic hepatitis after longtime alcohol abuse, poison intake like snake poison or after consumption of poisonous mushrooms.
Also drugs in toxic overdose can lead to hepatitis, as an example paracetamol. In addition to these forms of hepatitis, there are also autoimmune hepatitides, which lead to inflammation of the liver due to the body’s own processes. The body develops autoimmune antibodies which are directed against the liver cells.
However, this autoimmune hepatitis is considered a relatively rare disease pattern. As mentioned above, toxic causes can also lead to hepatitis. In addition to toxic substances in fungi, snake venom or drugs in overdose, hepatitis can also be caused by alcohol.
This leads to the death of liver tissue and thus to a loss of liver function. In the end, continued consumption of alcohol leads to a so-called fatty liver and ultimately to cirrhosis of the liver, which can lead to liver failure. Especially in western countries, excessive alcohol consumption is very often responsible for cirrhosis of the liver.
Symptoms of hepatitis
The symptoms of hepatitis are very variable in their expression.They range from complete freedom from symptoms, where the diagnosis is made solely on the basis of abnormal liver blood values, to fulminant liver failure. The symptoms of a hepatitis disease can be described roughly like this: At the beginning the patient complains about general indisposition like:
- Tiredness
- Lassitude
- Headaches
- Muscle and joint problems.
- Loss of appetite
- Nausea
- Vomiting and
- Weight loss.
A feeling of pressure in the right upper abdomen may indicate an enlargement of the liver. An infectious cause of the hepatitis may also be fever.
Later, jaundice (icterus) and its accompanying symptoms may develop. The billirubin (bile pigment) can no longer be excreted into the bile ducts by the affected liver cells (hepatocytes). A typical symptom complex of jaundice develops: a yellowing of the skin and the white color of the eyes (sclera) are the most obvious symptoms of jaundice.
An agonizing itching, caused by deposited bile salts in the skin, is particularly unpleasant for the patient. In addition, there is a loamy discoloration of the stool due to the absence of bile dye in the stool and a darkening of the urine because the kidney takes over the excretion of the bile dyes. Due to the absence of bile acids in the small intestine, fats can be digested more poorly, which can lead to intolerance to fatty meals and to fatty stools (steatorrhea).
Liver diseases typically show skin changes, which are then called hepatic skin signs. First and foremost, this includes jaundice (icterus). The bile pigment bilirubin is deposited under the skin and causes on the one hand the yellowing of the skin and additionally a certain itching.
Further signs of liver skin appear only after many years of damage to the liver, such as in liver cirrhosis and manifest themselves in certain vascular drawings in the abdominal area, varnished lips and varnished tongue, cloudy or whitish discoloration of fingernails and toenails and a parchment-like change in the skin. Basically, the various liver inflammations do not differ significantly in their initial symptoms. This is because unspecific signs such as tiredness and exhaustion, abdominal pain, nausea and vomiting as well as flu-like signs with a slight fever are often seen.
The suspicion of hepatitis is then often confirmed after yellowing of the skin, a so-called icterus. This yellowing often begins in the area of the eyes, as the sclera (sclera of the eye) becomes discolored. The first signs may also be absent in certain hepatitis viruses.
In hepatitis B, for example, symptoms are absent in two thirds of cases and only in one third of cases does an acute course of the disease with icterus occur. Hepatitis A also usually shows no symptoms in children. The older the person affected is, the more often a hepatitis A infection leads to a more serious course, especially if another hepatitis infection or liver disease is already present. Hepatitis C is characterized by jaundice.
