E. Watanabe

Acute hepatitis in the elderly with special reference to subacute hepatitis

Statistical analyses have been made on various liver function tests, done on admission, time required for normalization of liver function tests, and death rate in 53 cases over 60 years of age with infectious hepatitis, serum hepatitis and drug hepatitis, admitted to our department and hospitals affiliated to our department. The following results have been obtained. 1) Of 53 cases, 41 was infectious hepatitis and 10 was serum hepatitis and 2 was drug hepatitis. 2) The number of days required for the normalization of liver function tests, such as serum bilirubin, GPT and BSP test, between infectious hepatitis and serum hepatitis showed no satistical significance, and death rate between these group of hepatitis was insignificant. 3) Liver function tests at the onset was compared with three groups,--normalized group, prolonged group and died group. The various liver function tests indicated some tendency among thsse groups and especially high value of serum bilirubin and r-globulin at the onset suggested poor prognosis in both groups of hepatitis. 4) 11 patients died of subacute hepatitis or fulminant hepatitis and a mortality rate was 24.40 % in infectious hepatitis and 10.0% in serum hepatitis. Ten of 11 death cases had some complication, such as diabetes mellitus, hypertension, pulmonary tuberculosis and so on, It is suggested that such complication in addition to aging factor are important for the cause of death in acute hepatitis of the elderly.

Acute hepatitis in the elderly

94 cases of acute hepat i t is were observed in our clinic dur ing past 3 years. They included 48 cases of infect ious hepat i t is and 46 cases of serum hepati t is . F luminan t hepat i t is were 7 cases (7.5%), cholangioli t ic type were 11 ones (11.7%), included 6 who were older than 60 years. 3 cases (3.2%) of them were fatal, 6 (6.4%) progressed to l iver cirrhosis . 6 (12.5%) of infect ious hepat i t is progressed to prolonged or chronic hepati t is , while 14 (21.2%) of serum hepat i t i s did to them. Case report Case 1 was 61 years old female wi th dominant jaundice (total b i l i r u b i n > 2 0 m g / d l , total cho le s t e ro l>380mg/d l and a lka l inephospha tase>5 Bessey unites), under the diagnosis of extrahepat ic obs t ruct ion or in t rahepat ic cholestasis operat ion was done, but ext rahepat ic obstruct ion was not found. Her illness progressed to chronic cholangioli t is . Case 2 was 32 years old female. Dominant elevations of t r ansaminase act ivi ty were observed at six t imes dur ing 3 years, and she was diagnosed to acute hepat i t is by liver biopsy. In interval, her l iver funct ion tes ts showed normal value and biopsy specimens did normal feature. She was dignosed to chronic reccurent hepat i t is .