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Hepatitis A is an infectious disease of the liver caused by Hepatovirus A (HAV); [7] it is a type of viral hepatitis. [8] Many cases have few or no symptoms, especially in the young. [ 1 ] The time between infection and symptoms, in those who develop them, is two–six weeks. [ 2 ]
Many patients, once started on long-term immunosuppressive therapy, will remain on that treatment for life. Common practice is to discontinue immunosuppressive therapy after two or more years of normalized transaminases and IgG. However, approximately 90% of patients with autoimmune hepatitis will relapse after treatment has been stopped.
The standard serology panel for seroconversion include hepatitis B surface antigen, hepatitis B surface antibody for IgM and IgG, hepatitis B core antibody for IgM and IgG, and hepatitis B e-antigen. [61] In the typical disease course for hepatitis B, [62] the individual will first seroconvert for hepatitis B surface antigen (HBsAg).
Possible causes for high ALT levels are liver inflammation (hepatitis A, B, C, infectious mononucleosis, acute viral fever, alcohol, pancreatic disorder), injury to muscles (trauma, myocardial infarction, congestive heart failure, acute kidney failure), and many toxins and drugs.
Ninety-six percent of patients with lupus induced by procainamide will have a positive test for anti-histone antibodies, and 100% of patients whose lupus was induced by penicillamine, isoniazid, or methyldopa will have a positive test for anti-histone antibodies. In 70% of patients with rheumatoid arthritis, Felty's syndrome, Sjogren's syndrome ...
Secondary cold agglutinin syndrome occurs when autoantibodies bind to red blood cells, rendering them subject to attack by the complement system. [17] It is a result of an underlying condition potentially associated with either monoclonal cold-reacting autoantibodies or polyclonal cold-reacting autoantibodies [16] predominantly caused by infection or lymphoproliferative disorders. [16]
Both IgM and IgG antibodies bind strongly with their complementary antigens. IgG antibodies are most reactive at 37°C. IgM antibodies are easily detected in saline at room temperature as IgM antibodies are able to bridge between RBC's owing to their large size, efficiently creating what is seen as agglutination .
In acute viral hepatitis, the GGT levels can peak at 2nd and 3rd week of illness, and remained elevated at 6 weeks of illness. GGT is also elevated in 30% of the hepatitis C patients. GGT can increase by 10 times in alcoholism. GGT can increase by 2 to 3 times in 50% of the patients with non-alcoholic liver disease.