An unusual combination of relapsing and cholestatic hepatitis A in childhood.
Clinical variants of hepatitis A include the prolonged, relapsing and cholestatic forms. Here, the first childhood case of hepatitis A, with a combination of the relapsing and cholestatic forms is presented, a 14-year old boy. In the first phase of the illness, while the AST and ALT levels were declined, th total and direct bilirubin and GGT were increased. The patient was thought to have the cholestatic form of hepatitis A. Du to intense pruritus and high bilirubin levels, ursodeoxycholic acid (UDCA) therapy was started. On the 17th day, the decreased AST and ALT levels began to increase, reaching levels as high as 484 U/L and 862 U/L, respectively. The UDCA treatment was stopped on the 64th day. On the 164th day, all his laboratory parameters were within normal limits, but the anti-HAV IgM was still positive.
Department of Pediatrics, Atatürk University, School of Medicine, Erzurum, Turkey. vdinar@turk.net
Vildan
V
Ertekin
Mukadder Ayşe
MA
Selimoğlu
Zerrin
Z
Orbak
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002779:Cholestasis / Q000145:classification / Q000188:drug therapy / Q000209:etiology*; D006506:Hepatitis A / Q000150:complications*; D006801:Humans; D008297:Male; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D014580:Ursodeoxycholic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase