Hepatitis A in Children- Clinical Course, Complications and Laboratory Profile

作者：Kumar K Jagadish^*; Kumar H C Krishna; Manjunath V G; Anitha C; Mamatha S

来源：Indian Journal of Pediatrics, 2014, 81(1): 15-19.

DOI：10.1007/s12098-013-1114-8

• Children
• Complications
• Hepatic failure
• Hepatitis A

To study the course and complications of hepatitis A in children.
Seventy eight children diagnosed as acute viral hepatitis A by IgM antiHAV were prospectively studied for involvement of other systems and complications.
The mean age of children was 7.85 +/- 3.4 y. Jaundice was present in all the patients as this was the inclusion criteria. Fever was present in 82.1 %, hepatomegaly in 98.7 % and splenomegaly in 39.7 %. More than 5 fold rise in Aspartate transaminase (AST) and Alaninetransaminase (ALT), were seen in 62 cases (79.5 %) and 55 cases (70.5 %) respectively. Coagulopathy (Prothrombin time INR > 1.5) was observed in 12 cases (15.4 %) and abnormal APTT in 10 cases (12.8 %). Thrombocytopenia was observed in 5.1 % of children and 8.9 % had more than 2 hematological abnormalities. Ascites was noted in 35 cases (44.9 %), gallbladder wall thickening in 32 cases (41 %) and pleural effusion in 11 cases (14.1 %). Acute renal failure, acute glomerulonephritis and acute pancreatitis were present in 1 case (1.3 %) each. Raised CK-MB values more than 3 times the normal was noted in 5 cases (6.4 %). On follow up, most of the children recovered completely by 2 mo and prolonged cholestasis was observed in 2 of them. In the present study mortality was 1.3 % and it was attributable to fulminant hepatic failure.
Eventhough hepatitis A infection is a self-limiting disease, extrahepatic manifestations and mortality are not uncommon. All cases should be followed up till complete recovery and only a strong index of suspicion will enable us to recognize the complications.

• 出版日期2014-1