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In a 4-year follow-up study, patients with acute sporadic non-A, non-B (NANB) hepatitis were evaluated to determine the etiology and natural history of the disease. Acute hepatitis C virus (HCV) was detected in 13 of 43 (30%) of patients, anti-hepatitis E virus (HEV) IgG in 5 (12%), and 25 (58%) were considered non-A-E. The HCV RNA was detected in all HCV patients but none of the non-A-E cases. The initial clinical and biochemical presentation of the HCV and non-A-E cases was quite similar, although 2 of the non-A-E patients had severe disease. The 5 patients who were found to be anti-HEV IgG-reactive recovered within 6 months of follow-up. Of the 13 HCV cases, alanine transaminase (ALT) levels returned to normal in 7 (53.8%), while 6 (46.2%) continued to show abnormal ALT after 6 months of follow-up. However, 9 (69.2%) of them remained HCV-RNApositive, denoting virological/biochemical dissociation. Longterm follow-up showed a reappearance of HCV RNA in 2 of the 4 patients who were in virological remission performing 84% of chronicity rate. Acute non-A-E hepatitis patients were less likely to evolve toward chronicity, as compared with acute HCV cases (16% vs. 84%; P ‫؍‬ .0001). Only 4 (16%) of the non-A-E patients were hepatitis G virus (HGV)-RNA-positive. Concerning risk factors for acquiring parenterally transmitted viruses, tattooing was the only one that could be associated with HCV transmission (P ‫؍‬ .002). No risk factors could be identified for putative non-A-E virus transmission. Liver biopsies performed for chronic HCV patients showed a variable degree of inflammation, while the non-A-E patients presented less severe histological disease. (HEPATOLOGY 1999;30:289-293.)

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ResumoA pancreatite aguda é um processo inflamatório do pâncreas, decorrente da ação de enzimas inadequadamente ativadas, que causam edema, hemorragia e até necrose pancreática e peripancreática. As células acinares presentes no pâncreas assim como as células estelares pancreáticas tem sido alvo de estudo como participantes na formação do processo inflamatório juntamente com outras células inflamatórias. Diversas citocinas são liberadas durante a pancreatite, e assim, o processo inflamatório inicialmente local, pode ter uma repercussão sistêmica importante, e o paciente poderá apresentar hipovolemia, comprometimento de múltiplos órgãos e sistemas e possibilidade de óbito. A condição clinica da pancreatite na forma leve ou grave dependerá da extensão do processo e das complicações que podem advir. Palavras-chave: Pancreatite aguda -Citocinas -Necrose pancreática. Abstract The acute pancreatitis is an inflammatory process of the pancreas, resulting from the action of enzymes activated inappropriately, causing swelling, bleeding and even pancreatic necrosis and peripancreática. The acinar cells in the pancreas and stellar cells pancreatic has been the study as participants in shaping the inflammatory process along with other inflammatory cells. Several cytokines are released during pancreatitis, and thus, the local inflammatory process initially, may have an important