title: Acute hepatitis A: combination of the relapsing and the cholestatic forms, two rare variants.
abstract: Here we present an unusual case of a 23-year-old, otherwise healthy man who had a biphasic form of viral hepatitis A with a combination of two variants, the relapsing and cholestatic forms. One month after resolution of the first phase of acute hepatitis A, he was readmitted with jaundice and intense pruritus. During hospitalization, his serum bilirubin level increased to 50.2 mg/dL, with a slight increase in the other levels of liver enzymes. He was treated with ursodeoxycholic acid and later with corticosteroid therapy, resulting in resolution of symptoms and improvement of his liver function tests after 2 weeks. Medication therapy seems to be justified in markedly symptomatic patients with relapsing hepatitis.
authors.affiliation: Recanati Center for Medicine and Research, Rabin Medical Center, Petach-Tikva, Israel.
authors.forename: C M
authors.initials: CM
authors.lastname: Rachima
authors.forename: E
authors.initials: E
authors.lastname: Cohen
authors.forename: M
authors.initials: M
authors.lastname: Garty
mesh_terms: D000208:Acute Disease; D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002780:Cholestasis, Intrahepatic / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D006506:Hepatitis A / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D012008:Recurrence; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D001219:Aspartate Aminotransferases; D001663:Bilirubin