| In recent years, with the improvement of diagnostic and medical techniques, most ofpatients with abnormal liver function can confirm the diagnosis by laboratory examination,histology and other methods, then get treated properly. Another patients, that still could notbe made definite diagnosis, are called "unexplained liver disease", that including the"cryptogenic hepatitis" and "cryptogenic cirrhosis"[1-3]. In other words, cryptogenichepatitis is an inflammation of the liver that is unexplained by current diagnostic means andmethods[4]. The pathogenesis is unclear, and the characteristics of clinic and histology arenot obvious. The incidence of cryptogenic hepatitis is about5%~30%[1,2]. At present, theclinical diagnosis of cryptogenic hepatitis mainly depend on the exclusion of the other liverdiseases that have a precise etiology. Etiological classification and characteristics of clinicand histology with cryptogenic hepatitis have been changed, with the further insight intothe pathogenesis and etiology of relevant liver diseases, the application of novel diagnostictechniques and methods, and the changes of human’s production modes and lifestyles[4,5].Patients with serum elevated alanine aminotransferase (ALT) levels from2010to2013were randomly selected in this study. A standardized road-map for diagnosis of cryptogenichepatitis was established. Patients passed through screening, detailed examination, andfollow-up stages as necessary. Several kinds of diagnosis methods, including highlysensitive detection of virus nucleic acid and liver histology and immunohistochemistry wereapplied to find out the etiology. Then the patients with cryptogenic hepatitis were screenedout. Meanwhile, the clinical data of the patients with cryptogenic hepatitis were pooledanalyzed; the liver tissue slices were read by multiple readers independently and blindly(the readers were unknown to the informations of the patients). At last, the characteristics ofthe clinic and histology in patients with cryptogenic hepatitis were investigated.Results(1) After detailed examination and/or follow-up for months,12.2%in patients with cryptogenic hepatitis could not be diagnosed.(2) The levels of ALT, serum total bilirubin (TBIL) and prothrombin time (PT) in thepatients with cryptogenic hepatitis were (640.01±596.67) IU/L,(118.41±142.64) μmol/Land (13.18±7.70) sec respectively. There was no difference in the distribution of ALT levelin different age groups (2=2.629，P＞0.05). There was significant difference in thedistribution of TBIL level in different age groups (2=23.927，P＜0.05).(3) The symptoms of the patients with cryptogenic hepatitis included: fatigue (53.3%),digestive symptoms (54.9%), and jaundice (50.0%); the disease duration tended to besubacute and chronic (79.7%), patients got good prognosis (72.1%).(4) Most clinical histological patterns of the patients with cryptogenic hepatitis weremild chronic hepatitis (63.4%~84.1%); the major inflammatory activity grade coveredG1~G2(64.6%~85.4%), while the fibrosis stages were mostly S0~S1(73.1%~6.9%).Conclusions(1) It could improve the efficiency for the diagnosis of cryptogenic hepatitis by varioussensitive and specific diagnostic tools and through several periods for confirming.(2) Clinic characteristics of cryptogenic hepatitis covered: A. onset mostly in youngadults; B. most conditions of subacute and chronic, while part of repeated episode; C.symptoms of weakness, digestive symptoms, jaundice and others in above half patients; D.good prognosis.(3) Liver histological characteristics of cryptogenic hepatitis were as follows: A. mildand moderate hepatic impairment were observed in most patients; B. chronic change wasthe major mode; C. most inflammatory activity grades and fibrosis stages were G1~G2andS0~S1respectively.(4) Some characteristics of clinic and histological of patients were similar betweencryptogenic hepatitis and viral hepatitis. |
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