Serologic Testing for the Diagnosis of Hepatitis B Virus (HBV) Infection

The antigens and antibodies associated with HBV infection include HBsAg (Australia antigen) and antibody to HBsAg (anti-HBs), hepatitis B core antigen (HBcAg) and antibody to HBcAg (anti-HBc), and hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe). At least one serologic marker is present during the different phases of HBV infection.

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Criteria for Acute Upper Gastrointestinal Hemorrhage

Acute upper gastrointestinal (GI) bleeding is common and potentially life-threatening and needs a prompt assessment and aggressive medical management. All patients need to undergo endoscopy to diagnose, assess, and possibly treat any underlying lesion.

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The Rockall Scoring System

The Rockall score is an established and useful system to assess upper gastrointestinal bleeding (UGIB). The Rockall system has been shown to represent an accurate and valid predictor of rebleeding and death, performing better in the latter than in the former. Rockall scores are designed to combine information such as the subject’s age, occurrence of shock assessed from systolic blood pressure readings and pulse rate, presence and severity of comorbid conditions, diagnosis and endoscopic stigmata of recent bleeding.

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Diagnosis of Gilbert’s Syndrome

Gilbert syndrome is a genetic condition and this autosomal recessive condition is characterized by intermittent jaundice in the absence of hemolysis or liver disease.
The hyperbilirubinemia is mild. By definition, bilirubin levels in Gilbert syndrome are lower than 6 mg/dL, though most patients exhibit levels lower than 3 mg/dL. Gilbert syndrome is the result of a genetic mutation in the promoter region of a gene for the enzyme UGT1A (bilirubin–uridine diphosphate glucuronyl transferase).

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Traditional Diagnostic Criteria for Hereditary Hemochromatosis

Hereditary hemochromatosis has been traditionally defined as an inherited disorder characterized by inappropriately high absorption of dietary iron, which leads to abnormal accumulation of iron in parenchymal organs. In 1996, the HFE gene was isolated on chromosome 6. Since this finding hereditary hemochromatosis has been defined by some as the presence of a homozygous defect in the HFE gene with direct or indirect evidence of iron overload.

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