Question 25 / 32:  A 34 year-old patient is admitted to the hospital for detox from intravenous drug use. A medical examination reveals marked elevations in the liver function tests. The total bilirubin is 3.4, AST 1,245, ALT 1,435, Alkaline phosphatase 85. The patient is diagnosed with hepatitis B.

Which of the following sets of serologic tests would you most likely find in this patient?

Hepatitis BHepatitis BHepatitis B coreHepatitis B eHepatitis B e
surface antigensurface antibodyIgM antibodyantigenantibody
ANegativePositiveNegativeNegativeNegative
BNegativeNegativePositiveNegativeNegative
CPositiveNegativeNegativePositiveNegative
DPositiveNegativePositivePositiveNegative
EPositivePositivePositiveNegativeNegative

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Explanation:

Case of acute hepatitis B due to marked elevations in liver blood tests. In acute hepatitis B the Hepatitis B core IgM antibody is always elevated. The hepatitis B surface antigen is also typically positive. The Hepatitis B e antigen is also often elevated as a marker of active viral replication.

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Attribution:  Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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