| [ Summary ] |
Acute liver injury is associated with infection by various viruses other than hepatitis viruses. These include the Epstein-Barr virus, cytomegalovirus, herpes simplex virus, human herpes virus type 6, parvovirus B-19, rubella virus, measles virus, varicella-zoster virus, human immunodeficiency virus, and so on. Each viral infection is characterized by unique clinical manifestations, and is diagnosed with elevated titers of specific IgM type antibodies and also by detection of a viral genome in the blood. Laboratory data will indicate increased levels of serum lactate dehydrogenase, compared with those of transaminases, as the common feature of liver injury associated with infection of these viruses. Mononucleosis in the peripheral blood, including the presence of atypical lymphocytes, is another feature commonly observed. Histological examination of liver biopsy specimens demonstrates relatively mild findings such as non-specific changes, mild focal necrosis, or the recovery phase of acute hepatitis. In clinical practice, exclusion of other causes of liver injury is also important. Four out of five causes of hepatitis, such as hepatitis viruses, drugs, alcohol, or autoimmune conditions, must be ruled out. Other causes contributing to elevated transaminase levels, such as fatty liver or congestion, should also be ruled out. |