Hyperechoic liver steatosis: is it normal if hepatitis A and hepatitis B?

Several conditions may have the same events and only specific tests can differentiate them. These cases are more difficult for us to understand and sometimes raise many questions. The answers are not always obvious, let the doctors rather delicate task ...
At the ultrasound, a hyperechoic liver steatosis is a shiny appearance, the difference in contrast between the vessels and the hepatic parenchyma is not clear, the different structures are visible and difficult to distinguish months.
A hyperechoic liver steatosis is essentially an ultrasound evidence of liver steatosis.

Fatty liver is a condition characterized by an accumulation of fat in liver cells. These lipids are mainly triglycerides, a phenomenon secondary to several mechanisms:
- Either to an excess production of triglycerides in the liver. This mechanism is essentially encountered an excess of dietary fatty acids in obese and diabetic people.
- Or poor drainage of triglycerides by the liver cells (hepatocytes) in the blood secondary to a deficiency in proteins responsible for transport.
- Either by disruption in the functioning of liver enzymes, causing an excess of food metabolism in favor of overproduction of triglycerides. This mechanism is mainly due to an excess of alcohol or secondary effects of certain drugs consumption. This problem enzyme level can be linked to an enzyme deficiency congenital.

Are distinguished mainly by their cause and histological feature two (2) types of fatty liver disease:
- The alcoholic fatty liver disease
- Non-alcoholic fatty liver disease

Several factors favor the risk of developing non-alcoholic fatty liver disease, such as:
- Diabetes
- Obesity
- The history of surgery in the abdomen
- Certain medications: corticosteroids, antiretroviral drugs used in blocking the immune system, drugs used in chemotherapy ...

In general, viral hepatitis, alcoholic liver disease origin, autoimmune hepatitis is a differential diagnosis of NAFLD. According to the pathogenic mechanism, causes of NAFLD are mainly related to being overweight, diabetes and hypertriglyceridemia.

However, cases of hepatic steatosis were found in the context of a viral hepatitis, but this mainly concerns the hepatitis C, the correlation between these two liver disease is related to the chronicity of viral hepatitis C . And it is not uncommon for a fatty liver occurs concomitantly with other chronic liver diseases pace. Biopsy only to differentiate the histological characters and make specific diagnoses.

The presence of viral hepatitis A, viral hepatitis B, with an aspect of ultrasound liver steatosis should be further exploration. Biopsy alone can decide on the concomitant existence or not of these three hepatic injury, including the origins, evolution terms and conditions of absorptions are completely different. The search for risk factors associated with hepatic steatosis is mandatory.

The viral hepatitis is diagnosed primarily from serology for the detection of antibodies and antigens.
The ultrasound is not systematic and has no particular diagnostic value in these conditions. It is most often normal or inflammatory liver slightly enlarged.

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Hepatitis