Hepatitis E physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Patients with hepatitis E typically have a normal physical exam. Symptomatic patients may present with: fever, jaundice, hepatomegaly and splenomegaly, and in more advanced stages of the disease neurological manifestations, such as confusion and motor deficits.[1][2][3]
Physical Examination
Vitals
Temperature
- A fever may be present
Pulse
Rate
- Tachycardia may be present
Respiratory Rate
- Tachypnea may be present
Skin
- Jaundice may be present
- Palmar erythema may be present
- Spider angiomata may be present
Eyes
- Icteric sclera may be present
Abdomen
- Abdominal distention may be present
- Abdominal tenderness may be present, particularly on the right upper quadrant
- Hepatomegaly may be present
- Splenomegaly may be present
Neurologic
- Asterixis may be present
- Neurologic manifestations, in cases of HEV progression to hepatic encephalopathy, include a wide spectrum of cognitive impairment and motor system abnormalities.[4]
Extrahepatic Manifestations
- Arthralgia
- Palpable purpura
References
- ↑ Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J; et al. (2012). "Hepatitis E." Lancet. 379 (9835): 2477–88. doi:10.1016/S0140-6736(11)61849-7. PMID 22549046.
- ↑ Wedemeyer H, Pischke S, Manns MP (2012). "Pathogenesis and treatment of hepatitis e virus infection". Gastroenterology. 142 (6): 1388–1397.e1. doi:10.1053/j.gastro.2012.02.014. PMID 22537448.
- ↑ Aggarwal R, Jameel S (2011). "Hepatitis E." Hepatology. 54 (6): 2218–26. doi:10.1002/hep.24674. PMID 21932388.
- ↑ Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD; et al. (2014). "Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study Of Liver Diseases and the European Association for the Study of the Liver". Hepatology. 60 (2): 715–35. doi:10.1002/hep.27210. PMID 25042402.