Poster 1173 A Rare Case of Athlete’s Hepatitis in a Young, Healthy Marathon Runner
Author Insight from Ritesh Kanotra, MD
What’s new here and important for clinicians?
As a physician, you need to know two things: What athlete’s hepatitis is and how to diagnose it.
- It’s a pathologic state in which extreme exercise will cause decrease in blood flow to the liver tissues, resulting in transient elevation of your liver function test to about 2x normal, and will often trend down on its own over about 1 week.
- How do you diagnose it? It’s all in the history. If you see abnormal elevation in liver function tests in a patient, it’s extremely important to ask your patients if they are involved in an extreme exercise program. And if they are, and you find no other reason for them to have abnormal liver function test, then the patient likely has athlete’s hepatitis.
So if you can recognize this, you can avoid ordering unnecessary testing for a further work-up. Of course if the history suggest an alternative diagnosis, you should order specific tests to find the underlying disease process.
What do patients need to know?
It’s good to exercise, but in moderation. If you happen to be involved in extreme exercise such as marathon running or heavy weightlifting, you need to keep yourself well hydrated and avoid overuse of any drugs that may dehydrate you, such as caffeine / alcohol, or those that are toxic to your liver, including a drug as readily available as OTC Tylenol. If you have to go for routine blood tests, avoid extreme exercise at least for a week prior to getting tested.
**So remember athlete’s hepatitis, diagnose it, and save the healthcare system millions of dollars in the long run.
Chart: Trend of Patients liver function test from 9/29/14 to 10/04/14
Author Contact Ritesh Kanotra, MD
Twitter: @DrKanotra
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