Pediatric Hepatitis B Differential Diagnoses

  • Author: Nicholas John Bennett, MB, BCh, PhD; Chief Editor: Russell W Steele, MD   more...
 
Updated: May 15, 2012
 
 

Diagnostic Considerations

Viral hepatitis shares certain clinical features with other viral diseases (eg, Epstein-Barr virus, herpes simplex, coxsackieviruses) and toxoplasmosis. These diseases elevate serum aminotransferase levels and, less commonly, serum bilirubin levels.

In addition, a complete drug history is particularly important because many drug and some anesthetic agents can produce a picture of acute hepatitis. Alcoholic hepatitis must also be considered in the differential. Acute hepatitis often is confused with acute cholecystitis, common duct stone, or ascending cholangitis.

See also Pediatric Hepatitis A, Pediatric Hepatitis C, and Viral Hepatitis.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Nicholas John Bennett, MB, BCh, PhD,  Assistant Professor in Pediatrics, Division of Infectious Diseases, Connecticut Children's Medical Center

Nicholas John Bennett, MB, BCh, PhD, is a member of the following medical societies: Alpha Omega Alpha and American Academy of Pediatrics

Disclosure: Nothing to disclose.

Coauthor(s)

Poonam Sharma, MD  Assistant Professor, Department of Pathology, Creighton University Medical Center and Veterans Affairs Medical Center; Director of Pathology Course, School of Pharmacy and Health Professions, Creighton University Medical Center

Poonam Sharma, MD is a member of the following medical societies: College of American Pathologists and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Meera Varman, MD  Associate Professor, Department of Pediatrics, Section of Pediatric Infectious Diseases, Creighton University Medical Center

Meera Varman, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: phamaceutical companies Honoraria speaker; phamaceutical companies Grant/research funds clinical trials research

Athena P Kourtis, MD, PhD  Associate Professor, Department of Pediatrics, Divisions of Infectious Diseases and Epidemiology, Emory University School of Medicine; Senior Fellow, Centers for Disease Control and Prevention

Athena P Kourtis, MD, PhD is a member of the following medical societies: American Academy of Pediatrics and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Sanjeev Sharma, MD, MBA, FRCS(Ed)  Assistant Professor, Department of Family Medicine, Creighton University School of Medicine

Sanjeev Sharma, MD, MBA, FRCS(Ed) is a member of the following medical societies: Royal College of Surgeons of Edinburgh

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Alexander T Kessler , MD Private Practice, Canton, GA

Disclosure: Nothing to disclose.

Mark R Schleiss, MD American Legion Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
  1. Kane M. Global programme for control of hepatitis B infection. Vaccine. 1995;13 Suppl 1:S47-9. [Medline].

  2. Izzo F, Cremona F, Ruffolo F, et al. Outcome of 67 patients with hepatocellular cancer detected during screening of 1125 patients with chronic hepatitis. Ann Surg. Apr 1998;227(4):513-8. [Medline].

  3. Bhimma R, Coovadia HM, Adhikari M, Connolly CA. The impact of the hepatitis B virus vaccine on the incidence of hepatitis B virus-associated membranous nephropathy. Arch Pediatr Adolesc Med. Oct 2003;157(10):1025-30. [Medline].

  4. Chisari FV, Isogawa M, Wieland SF. Pathogenesis of hepatitis B virus infection. Jan 28. [Epub ahead of print] 2010;[Medline].

  5. Viral Hepatitis Topics. www.cdc.gov. Available at http://www.cdc.gov/hepatitis/statistics.htm.

  6. Murray KF, Szenborn L, Wysocki J, Rossi S, Corsa AC, Dinh P, et al. Randomized, placebo-controlled trial of tenofovir disoproxil fumarate in adolescents with chronic hepatitis B. Hepatology. Apr 27 2012;[Medline].

  7. [Best Evidence] [Guideline] Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. Sep 2009;50(3):661-2. [Medline]. [Full Text].

  8. [Best Evidence] Sorrell MF, Belongia EA, Costa J, et al. National Institutes of Health Consensus Development Conference Statement: management of hepatitis B. Hepatology. May 2009;49(5 Suppl):S4-S12. [Medline]. [Full Text].

  9. Shi Z, Yang Y, Wang H, et al. Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus: A Meta-analysis and Systematic Review. Arch Pediatr Adolesc Med. Sep 2011;165(9):837-46. [Medline].

  10. Rugge JB, Lochner J, Judkins D, Mendoza M. What is the best surveillance for hepatocellular carcinoma in chronic carriers of hepatitis B?. J Fam Pract. Feb 2006;55(2):155-6. [Medline].

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