A diagnostic approach to different types of non-A non-B acute hepatitis through the evaluation of the lobular distribution of hepatocytic damage.

The activity in the serum of three hepatic mitochondrial enzymes, glutamate dehydrogenase (GDH), ornithine carbamyl transferase (OCT) and mitochondrial glutamic oxaloacetic transaminase (m-GOT), all of which show different lobular distribution in the liver, was investigated in order to clarify the usefulness of determinations of these enzymes for the diagnosis of different types of acute non-A non-B (NANB) hepatitis. In NANB hepatitis, there were two different histological types: portal and non-portal. In most portal cases, the GDH/OCT ratios were lower than 0.35, but the ratios were higher than 0.36 in all non-portal cases. The prognosis of the portal group and the short incubation group of NANB hepatitis was better than that of the non-portal and the long incubation group, respectively. The cases showing GDH/OCT ratios of less than 0.35 clearly displayed better prognoses than the cases showing high GDH/OCT ratios. These findings implied that the low GDH/OCT group may have been infected by particular viruses and that ratio determination is useful for the diagnosis of NANB hepatitis caused by different viruses.