Symptoms of jaundice hepatitis

Jaundice hepatitis is also a type of hepatitis. When the disease occurs, patients often feel chills and fever, and it is sometimes mistaken for rubella. However, the symptoms are actually similar, so it is necessary to pay attention to examination and treatment to prevent infection.

(1) Loss of appetite, nausea, and vomiting

The pre-jaundice period is from the time the patient begins to have symptoms to the time when jaundice appears, which is about a few days to 2 weeks. At the onset of the disease, patients often feel chills and fever, with a body temperature of around 38°C. A few patients may have a high fever for several days. The more prominent symptoms are general fatigue, loss of appetite, nausea, vomiting, especially aversion to greasy food, fullness and stuffiness in the upper abdomen, yellow urine like strong tea, and loose stools or constipation. During this stage, due to individual differences and complex and diverse patient manifestations, it is easy to be misdiagnosed, and special attention should be paid. For example, some patients present with upper respiratory tract inflammation, similar to a cold. Some patients may experience joint pain and be mistaken for rheumatism. A small number of people also have severe abdominal pain and mistakenly think it is acute abdomen. A small number of people may also develop measles. At the end of this period, physical examination may reveal percussion pain and tenderness in the liver area. The liver can be touched below the rib margin in more than half of the patients. Serum alanine aminotransferase (ALT) is significantly elevated and urine bilirubin is positive. Hepatitis B surface antigen is positive and hepatitis B core antibody immunoglobulin M (anti-HBcIgM) is positive. During this period, the patient's blood, feces, urine, and vomit contain a large amount of hepatitis virus, making it highly contagious.

(2) Itchy skin and bradycardia

Jaundice appears after the fever subsides during the icteric period. The sclera is often the first to turn yellow, followed by yellowing of the entire body, reaching its peak within a few days to 2 to 3 weeks. Most cases have mild to moderate jaundice. At this time, gastrointestinal symptoms worsen, the liver is enlarged, with tenderness and percussion pain; in a few cases, the spleen is enlarged and can be touched under the marginal margin. Some patients also experience skin itching, bradycardia, abdominal pain and rash. After resting for a few days, the patient's nausea was relieved, vomiting disappeared, and appetite gradually improved. The white blood cell count is generally normal or slightly low, the lymphocyte count is high, and a small number of abnormal lymphocytes may be present. Urine bilirubin and urobilinogen are positive (urobilinogen may be temporarily negative in patients with very deep jaundice and grayish white stool). The serum ALT activity increases significantly, often above 400u, and this period lasts for 2 to 6 weeks or longer.

(3) Concurrent myocarditis and pericarditis

During the recovery period, jaundice, liver enlargement and other symptoms gradually subside, appetite returns to normal, but mild pain in the liver area still exists. This period lasts an average of one month. In a few cases, jaundice is significant and lasts for several months. Fatigue, liver pain and gastrointestinal symptoms are not very obvious. Liver function shows obstructive jaundice, and ALT is only slightly or moderately elevated. This is called cholestatic hepatitis. Complications: A small number of cases may be complicated by one or more of the following: myocarditis, pericarditis, miliary viral pneumonia, pancreatic necrosis, diabetes, meningoencephalitis, acute polyradiculitis, acute hemolytic anemia, pancytopenia, aplastic anemia, thrombophlebitis, nephritis, orchitis, papular dermatitis, and multiple arthritis.