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 |
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