Nonspecific Reactive Hepatitis – Unknown or Forgotten Diagnosis? (Short Review and Invitation to Discussion)

Abstract

The purpose of the study was to analyze and summarize information from the sources of scientific literature on nonspecific reactive hepatitis. Materials and methods. Analytical and bibliosemantic methods were used in the study. The search was performed in Google Scholar, NCBI, PUBMED and Web of Science databases using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) recommendations. Results and discussion. Acute and chronic liver diseases rank as one of the leading places in the structure of pathology of internal organs. The consequence of these diseases in many cases is the development of cirrhosis of the liver, which ranks 11th among the leading causes of death and 15th among the causes of morbidity in the world. Among hepatopathies, nonspecific reactive hepatitis (code K75.2 for ICD-10; DB97 for ICD-11) is rarely mentioned and diagnosed – secondary hepatitis caused by several endogenous and exogenous factors that reflect the liver's response to any somatic disease. There are few publications on this problem, but there are many publications on the deviation of liver function tests: bilirubin, alanine and aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase in many pathological conditions, including in critically ill patients regardless of their trauma, cardiac and acute surgical pathology, intestinal disorders. Frequent signs of hepatic dysfunction in many diseases, along with a small number of clinical diagnoses of nonspecific reactive hepatitis, indicate a problem of underdiagnosis, which can be explained by the lack of clear clinical, laboratory and instrumental signs of this disease. Determination of biomarkers of the liver function used in routine clinical practice requires qualitative and quantitative clarification, ultrasound is not always informative, and computed tomography is not always available. This indicates the urgency of the problem of defining the concept and criteria for the diagnosis of nonspecific reactive hepatitis and the need for large-scale clinical studies, especially in critical conditions of various etiologies, in the pathogenesis of which are hemodynamic disorders and systemic inflammatory response. Conclusion. The low diagnosis of nonspecific reactive hepatitis can be explained not only by the ignorance of doctors, but also by the lack of clear diagnostic criteria. The true prevalence of nonspecific reactive hepatitis does not correspond to the frequency of pathology in clinical diagnoses