A 28-year-old man, who recently emigrated from the Philippines, was noted to have a positive…

A 28-year-old man, who recently emigrated from the
Philippines, was noted to have a positive tuberculin skin test result in the
clinic. His chest radiograph showed no active tuberculosis, and he denied any
symptoms of this infection, including weight loss, cough, or night sweats. To
prevent future disease, daily dosing with isoniazid was recommended for the
next 9 months. Two weeks after initiating therapy, the patient reported
progressive fatigue, intermittent bouts of nausea, and abdominal pain. He also
noticed darkened urine and light-colored stools. His sister noted a gradual
yellowing
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A 28-year-old man, who recently emigrated from the
Philippines, was noted to have a positive tuberculin skin test result in the
clinic. His chest radiograph showed no active tuberculosis, and he denied any
symptoms of this infection, including weight loss, cough, or night sweats. To
prevent future disease, daily dosing with isoniazid was recommended for the
next 9 months. Two weeks after initiating therapy, the patient reported
progressive fatigue, intermittent bouts of nausea, and abdominal pain. He also
noticed darkened urine and light-colored stools. His sister noted a gradual
yellowing of his eyes and skin. Blood tests showed a marked increase in serum
bilirubin and aminotransferases. The isoniazid was discontinued, and his
symptoms subsided with his liver enzymes normalizing.

Questions

A. Describe the subtypes of toxic hepatitis.

B. What typical histologic findings are noted during
uncomplicated acute hepatitis?

C. What is the pathogenesis of the clinical jaundice seen in
this patient?

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