Hepatitis E physical examination: Difference between revisions
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==Overview== | ==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.<ref name="pmid22549046">{{cite journal| author=Kamar N, Bendall R, Legrand-Abravanel F, Xia NS, Ijaz S, Izopet J et al.| title=Hepatitis E. | journal=Lancet | year= 2012 | volume= 379 | issue= 9835 | pages= 2477-88 | pmid=22549046 | doi=10.1016/S0140-6736(11)61849-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22549046 }} </ref><ref name="pmid22537448">{{cite journal| author=Wedemeyer H, Pischke S, Manns MP| title=Pathogenesis and treatment of hepatitis e virus infection. | journal=Gastroenterology | year= 2012 | volume= 142 | issue= 6 | pages= 1388-1397.e1 | pmid=22537448 | doi=10.1053/j.gastro.2012.02.014 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22537448 }} </ref><ref name="pmid21932388">{{cite journal| author=Aggarwal R, Jameel S| title=Hepatitis E. | journal=Hepatology | year= 2011 | volume= 54 | issue= 6 | pages= 2218-26 | pmid=21932388 | doi=10.1002/hep.24674 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21932388 }} </ref> | |||
==Physical Examination== | |||
===Vitals=== | ===Vitals=== | ||
====Temperature==== | ====Temperature==== | ||
*A [[fever]] may be present | *A [[fever]] may be present | ||
====Pulse==== | ====Pulse==== | ||
=====Rate===== | =====Rate===== | ||
*[[Tachycardia]] may be present | *[[Tachycardia]] may be present | ||
====Respiratory Rate==== | ====Respiratory Rate==== | ||
*[[Tachypnea]] may be present | *[[Tachypnea]] may be present | ||
===Skin=== | ===Skin=== | ||
*[[Jaundice]] | *[[Jaundice]] may be present | ||
*[[Palmar erythema]] may be present | *[[Palmar erythema]] may be present | ||
*[[Spider angiomata]] may be present | *[[Spider angiomata]] may be present | ||
===Eyes=== | ===Eyes=== | ||
*Icteric [[sclera]] may be present | *Icteric [[sclera]] may be present | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal distention]] may be present | *[[Abdominal distention]] may be present | ||
*[[Abdominal tenderness]] may be present | *[[Abdominal tenderness]] may be present, particularly on the right upper quadrant | ||
*[[Hepatomegaly]] may be present | *[[Hepatomegaly]] may be present | ||
*[[Splenomegaly]] may be present | *[[Splenomegaly]] may be present | ||
===Neurologic=== | ===Neurologic=== | ||
*[[Asterixis]] | *[[Asterixis]] may be present | ||
*[[Neurologic]] manifestations in cases of | *[[Neurologic]] manifestations, in cases of [[HEV]] progression to [[hepatic encephalopathy]], include a wide spectrum of [[cognitive]] impairment and [[motor system]] abnormalities.<ref name="pmid25042402">{{cite journal| author=Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD et al.| title=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. | journal=Hepatology | year= 2014 | volume= 60 | issue= 2 | pages= 715-35 | pmid=25042402 | doi=10.1002/hep.27210 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25042402 }} </ref> | ||
===Extrahepatic Manifestations=== | ===Extrahepatic Manifestations=== | ||
*[[Arthralgia]] | |||
*Palpable [[purpura]] | |||
* | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WS}} | |||
{{WH}} | |||
[[Category:Hepatitis|E]] | [[Category:Hepatitis|E]] | ||
[[Category:Viruses]] | [[Category:Viruses]] | ||
[[Category:Gastroenterology]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category: | [[Category:Hepatology]] | ||
Latest revision as of 22:07, 29 July 2020
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Hepatitis E Microchapters |
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Treatment |
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Hepatitis E physical examination On the Web |
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American Roentgen Ray Society Images of Hepatitis E physical examination |
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Risk calculators and risk factors for Hepatitis E physical examination |
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.