Gioannini P, Cariti G
Istituto di Malattie Infettive, Università degli Studi, Torino.
Minerva Gastroenterol Dietol. 1996 Sep;42(3):153-9.
Acute viral hepatitis has a rather homogeneous clinical pattern, excepting a few features which are related to the specific viral agent. However, a few cases may be defined "atypical", as fas as clinical features, transmission pattern, serology are concerned. These include cholestatic hepatitis syndrome, fulminant HEV hepatitis during pregnancy, neonatal hepatitis. Non-typical aspects may be observed when extrahepatic manifestations are present (cryoglobulinemia, bone marrow aplasia, guillain-Barré syndrome, peripheral neuropathy, skin involvement, etc.). Finally, viral hepatitis may be "atypical" when associated with other infections (malaria, typhoid fever, etc.), mostly in patients from tropical Countries.
急性病毒性肝炎具有相当一致的临床模式,除了一些与特定病毒病原体相关的特征。然而,就临床特征、传播模式、血清学而言,少数病例可能被定义为“非典型”。这些包括胆汁淤积性肝炎综合征、妊娠期戊型肝炎暴发性肝炎、新生儿肝炎。当出现肝外表现(冷球蛋白血症、骨髓再生障碍、格林-巴利综合征、周围神经病变、皮肤受累等)时,可能会观察到非典型方面。最后,病毒性肝炎与其他感染(疟疾、伤寒等)相关时可能是“非典型”的,这在热带国家的患者中最为常见。