Hepatocellular Jaundice Due to Hepatitis or Severe Liver Failure

CLINICAL DIAGNOSTIC MANUAL

Hepatocellular jaundice is a type of jaundice that originates in the liver due to an impairment in the processing and excretion of bilirubin. This condition can result from various liver diseases that damage hepatocytes, the cells responsible for metabolising bilirubin. When these cells are damaged, bilirubin accumulates in the body, leading to the characteristic yellowish discoloration of the skin and mucous membranes.

Pathology	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Hepatitis A	Jaundice, fatigue, fever, nausea, vomiting, abdominal pain, dark urine, pale stools	History of exposure to contaminated food or water, blood tests (elevated transaminases)	Positive serology for hepatitis A (anti-HAV IgM)
Hepatitis B	Jaundice, fatigue, fever, nausea, vomiting, abdominal pain, dark urine, pale stools, joint pain	History of exposure to blood or body fluids, blood tests (elevated transaminases)	Positive serology for hepatitis B (HBsAg, anti-HBc IgM)
Hepatitis C	Jaundice, fatigue, fever, nausea, vomiting, abdominal pain, dark urine, pale stools, many patients asymptomatic	History of exposure to contaminated blood, blood tests (elevated transaminases)	Positive serology for hepatitis C (anti-HCV), confirmation by PCR for HCV RNA
Alcoholic hepatitis	Jaundice, fatigue, fever, nausea, vomiting, abdominal pain, dark urine, pale stools, hepatomegaly	History of excessive alcohol consumption, blood tests (elevated transaminases, AST>ALT)	Liver biopsy, detailed clinical history
Drug-induced hepatitis	Jaundice, fatigue, fever, nausea, vomiting, abdominal pain, dark urine, pale stools	History of hepatotoxic drug use, blood tests (elevated transaminases)	Medication history, improvement after drug cessation, liver biopsy if necessary
Primary hepatoma (hepatocellular carcinoma)	Jaundice, weight loss, abdominal pain, hepatomegaly, fatigue, dark urine, pale stools	History of chronic liver disease (hepatitis B or C, cirrhosis), blood tests (elevated alpha-fetoprotein)	CT/MRI imaging, liver biopsy, blood alpha-fetoprotein analysis
Right-sided heart failure	Jaundice, fatigue, peripheral oedema, ascites, dyspnoea, hepatomegaly	History of heart disease, blood tests (elevated transaminases, elevated BNP)	Echocardiogram, liver function studies, CT/MRI imaging of the abdomen to assess liver congestion