S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) The Seoul Journal of Medicine The Seoul Journal of Medicine Vol. 01 No.2 (1960)
유행성 Virus간염의 임상상과 간침생검 조직상에 관한 연구
STUDIES ON CLINICAL. LABORATORY AND HISTOLOGICAL FINDINGS OF LIVER BIOPSY IN EPIDEMIC VIRAL HEPATITIS
- Issue Date
- 서울대학교 의과대학
- Seoul J Med, Vol.1 No.2, pp. 5-28
- This is a report of the clinical and laboratory
findings of acute viral hepatitis, based on 163cases
experienced in the ROKA during the period from
April to Sept. , 1960. These cases were followed
up for 12 weeks after the onset of jaundice.
Some of the prominent findings are as follows;
1. The jaundice appeared within 1 week after
the onset of illness among 31 out of 42 cases in
which the history could be confirmed.
2. The symptoms are classified into gastrointest·
inal and nervous symptoms. The frequency of
major gastrointestinal symptoms were: indigestion
(94%) , abdominal pain(92%)' anorexia(85%),
nausea(67%), diarrheaC42%), vomiting(29%),
com:tipation04%) ill orde r. The frequency of major
nervous symptoms were: fatigability(98%) , cigarette
distaste(78%), vertigo(75%), headache(74%),
thirst(58%), drawsinessC56%), itching sensation
(43%) and joint pain(30%) in orde r. These symptoms
were generally prominent in the early stages
However, the fatigability was persistently prolong•
ed, and the itching sensations were marked in the
3. The major signs, in order of frequency ,
were as follows: yellowishconjunctiva(98%), hepa'
tomegaly(84%) , tender liver(67%), skin rashes
(27%), splenomegalyC22%), spider angiomata
03%) and petechia of skin (3%). Tender liver
was most prominent during the 1st week, and so
were splenomegaly during the 2nd week, hepatomegaly
during the 4th week and skin rashes after
the 4th week after the onset of jaundice
4. The incidences of symptoms and signs usu
ally paralleled the severity of hepatic damage, but
occasionally some of the clinical findings which
tended to be persistently prolonged were not so.
During the early stages, within 2 weeks after the
onset of jaundice, hepatomegaly was less frequent
in severe cases than in less severe cases.
5. The peak of the serum bilirubin level occurred
ill the 1st week after the onset of jaundice
At that time, an average value of total serum
bilirubin was 14.8mg%, and the maximal level
was 44.7mg%. In early stages, direct reactive
bilirubin was relatively higher than in the recov'
ery stages. Positive correlation was found between
the serum bilirubin levels and the severity of
histological changes. While there was an anicteric
stage in the moderately severe case, there was
complete histologic healing in one post-hepatitic
6. The peak of the serum iron level was
reached in the 2nd week after the onset of jaundice;
it was a somewhat later manifestation com
pared to the peak of serum bilirubin leve l. The
average level of the peak was 245 gamma% with
one case showing a maximum level of 451 gam
rna%. It did not necessarily prallel the degree of
hepatic cell necrosis.
7. The maximal activity of serum transamin
ase was revealed in the 1st week after the onset
of jaundice: the average level of GP-T activity
was 515.17 units, with a maximum level of 1610
units. The average level of GO-T activity waS
426.04 units with a maximum level of 1570 units.
There was an apparent parallel between the rise
of GP-T activity and hepatic cell necrosis, and the
rise of GO-T activity and the degree of fibrosis.
8. In cases having no complications, alterations
of electrophoretic pattern of the serum proteins
generally showed a moderate decrease of albumin
and a moderate increase of gamma globulin, with
decrease in albumin in the earlier stages and a
rise of gamma globulin in the later stages. The
most marked rise of gamma globulin level was
seen in a case with the most severe fibrosis.