KAJIAN KES HEPATITIS A

PENGENALAN

Hepatitis A adalah penyakit hati yang disebabkan oleh hepatitis virus A.Ini merupakan keradangan hati yang tidak teruk dan mempunyai gejala akut.Secara amnya,penyakit ini bermula dalam masa 2-6 minggu selepas dijangkiti virus ini dan hanya bertahan tidak lebih dari dua bulan.Penyakit ini juga dikenali penyakit berjangkit kerana ia merebak agak mudah daripada mereka yang ada hubungan rapat.Tempoh pengeraman untuk hepatitis A adalah di antara 15-60 hari atau 3- 5minggu dengan purata tempoh pengeraman 30 hari.Pesakit yang telah terinfeksi boleh menghantar organisma seminggu sebelum dan seminggu selepas simptom kelihatan.Virus boleh merebak dengan pengambilan air minuman atau ais yang tercemar,buah-buahan dan sayur-sayuran yang tidak dimasak,atau buah-buahan dan sayur-sayuran yang dicuci dengan air tercemar.Selain itu,virus juga boleh merebak melalui pengusaha makanan yang telah dijangkiti.

SEJARAH

Mike adalah seorang remaja yang berusia 18 tahun yang dikesan dengan tiada selera makan,loya dan tidak selesa pada bahagian atas perut.Dua minggu sebelum itu,beliau telah mengalami beberapa arthralgia yang sederhana dijarinya selama 2 hari.Beliau biasanya merokok 20 batang sehari dan minum 2-3 gelas bir setiap hari.Beliau menyedari bahawa berlaku perubahan warna pada air kencingnya iaitu warna lebih gelap daripada biasa.Dia tidak mempunyai sejarah perubatan yang penting.Selepas melakukan pemeriksaan, dia didapati febril tetapi jaundis.

SIMPTOM

Simptom yang telah dialami oleh Johan ialah jaundis iaitu apabila kulit menjadi kuning dan mata putih menjadi kuning disebabkan oleh pigmen hempedu kuning atau coklat didalam darah.Selain itu,johan juga mengalami demam, kurang selera makan, sakit perut, mual, muntah-muntah, keletihan, air kencing berwarna gelap, sakit otot dan sendi.

KOMPLIKASI

Mike mengalami GIT iaitu pendarahan pada salur pencernaan yang boleh membawa kepada pengsan dan koma.Selain itu,beliau juga mengalami edema pada serebrum dan anemia aplastik.Pada peringkat akhir,beliau mengalami refleks kornea dan papilari,darah arteri meningkat, kegagalan pernafasan dan berlaku keruntuhan sebrovaskular.

KAEDAH KAJIAN

Diagnosis dan rawatan

Tiada rawatan khusus,walaupun rehat di atas katil adalah penting.Beliau perlu mengamalkan diet tinggi dalam karbohidrat,rendah lemak dan rendah protien.Selain itu beliau perlu mengambil vitamin tambahan terutama kumpulan B kompleks.Terapi intravena juga perlu di buat sekali sekala.Isoprinosine boleh meningkatkan imuniti sel pengantara T –limfosit.Manakala alkalies,beladonna dan anti-emetics perlu diberikan untuk mengawal pencernaan yang terganggu.Selain itu doktor akan mendiagnosis penyakit ini melalui tanda-tanda yang muncul dan mengesahkannya dengan melakukan ujian darah.Ujian fungsi hati juga boleh digunakan tetapi tetapi tidak digalakkan.Walau bagaimanapun,biopsi hati boleh dilakukan kerana boleh menentukan tahap kerosakkan hati.Iamerupakan prosedur yang selamat dan boleh membantu dalam diagnosis dan rawatan.

KESIMPULAN

Mike mengidap penyakit Hepatitis A disebabkan oleh aktiviti merokok dan minum minuman beralkohol terlalu banyak.Langkah-langkah yang perlu beliau ambil ialah dengan mengurangkan atau berhenti merokok dan minum minuman beralkohol.Selain itu beliau juga perlu mengamalkan diet yang tinggi dalam karbohidrat,rendah lemak dan rendah protien serta mengambil makanan tambahan terutama kumpulan B kompleks.

LAMPIRAN

An 18-year-old man presented with a 10-day history of anorexia, nausea and upper abdominal discomfort. Two weeks earlier, he had experienced some mild arthralgia in his fingers which lasted for 2 days. He normally smoked 20 cigarettes and drank two to three pints of beer each day, but had done neither for several days. He had noticed that his urine was much darker than normal. There was no significant medical history. On examination, he was afebrile but jaundiced. There were no needle tracks on his arms. His liver was just palpable and tender.

Hepatitis was diagnosed and confirmed by routine investigations. His serum bilirubin was 48┬Ámol/l (NR 1-20) with raised liver enzyme levels (aspartate transaminase 895iu/l (NR 5-45); alanine transaminase 760iu/l (NR 5-30)), and an alkaline phosphatase of 128iu/l (NR 20-85). A monospot test for infectious mononucleosis was negative. Hepatitis B surface antigen (HBsAg) was also negative but he had detectable IgM antibodies to hepatitis A virus. He was managed conservatively at home. There is no active treatment for hepatitis A infection, although rest may be beneficial. The clinical and biochemical evidence of hepatocellular damage subsided over the next 4 weeks but he continued to feel vaguely unwell for several months. A further blood sample after 6 months showed IgG antibody to hepatitis A.

History of Hepatitis A

If you arent familiar with Hepatitis A you should be. Theres a misconception about who is at risk, and although it is considered the least serious it still is serious. Lets start with a look at the history of Hepatitis A.

The History

Hepatitis is believed to date all the way back to ancient times. It was described a disease of the liver that caused the skin to yellow. It was in 1963 that serum hepatitis was identified and labeled Hepatitis B or HBV.

It took another ten years for Hepatitis A or HAV to be identified, and until 1989 for Hepatitis C or HCV to be isolated. Since then there have been other Hepatitis viruses identified.

Hepatitis A Identified

Once Hepatitis A was identified it was also better understood. Although the history of Hepatitis A dates it back to early times they didnt know what it was or how to treat it. Hepatitis inflammation of the liver hepar = liver and itis = inflammation.

Hepatitis A is an inflammation of the liver due to the A virus and is the most common hepatitis infection. It is also the least serious so it does not have long-term chronic effects. Once treated almost all make a complete recovery.

Signs and Symptoms of Hepatitis A

Symptoms can vary a great deal between individuals but what is common among most sufferers are the flu like symptoms, which can be severe.

Jaundice can also occur which is when the skin yellows and the whites of the eyes take on a yellow color that is a result of the yellow/brown bile pigment in the blood.

Symptoms cam also include fever, poor appetite, abdominal pain, nausea, vomiting, fatigue, dark urine, light stools, muscle, and joint pains. Your live might also be enlarged and tender.

How Do You Get Hepatitis A?

Hepatitis A is transmitted from person to person and the primary cause of spread is poor hygiene. Some areas of the world have a history of Hepatitis A such as South America, India, Central America, and Bangladesh. But 1/3 of al Americans are believed to have been exposed to Hepatitis A.

How Is Diagnosis Of Hepatitis A Done

Throughout the history of Hepatitis A much of it has gone undiagnosed. Its only when the symptoms exceed that of the flu that someone might seek medical intervention. Your doctor will diagnose Hepatitis A from the symptoms you presents, and then confirm that diagnosis with the use of a blood test to confirm that hepatitis is present.

Liver Function tests can be used but it is not good for accessing all of the varied functions that your liver provides for your body. When Hepatitis A is present Immunoglobulins, Prothrombin, and Albumin are abnormal.

A liver biopsy can be done and in fact it is the most accurate test available. It can determine just how badly the liver is damaged. It is a relatively safe procedure that can be very helpful in diagnosis and then treatment.

Hepatitis A Treatment

Throughout the history of Hepatitis A the most common treatment includes bed rest, but it really all depends on the severity of the symptoms. If you are feeling well enough you can go to work. In less than 1% of Hep A sufferers intensive care hospital treatment may actually be required.

Of this 1% of serious cases 30% will die if they do not receive a liver transplant and of those that receive a liver transplant 80% will return to normal.

Although the history of Hepatitis A goes back to the earliest times, for most this remains more of an inconvenience than a life threatening illness. However if you are exposed to Hepatitis A you need to do your part to prevent the spread of it, rest, and hopefully get back to health in no time.