title: Hepatitis A--frequency in children with non-specific abdominal symptoms.
abstract: OBJECTIVE
  To study the frequency of subclinical hepatitis 'A' in children having non-specific abdominal symptoms.
  
  
  METHODS
  A descriptive study.
  
  
  METHODS
  This study was conducted at Combined Military Hospital (CMH), Peshawar from June to December 2000.
  
  
  METHODS
  Three hundred and sixty children of either gender, < 12 years of age, presenting with vague abdominal symptoms and no jaundice were evaluated for hepatitis. Eighty eight (24.4%) children meeting the inclusion criteria of elevated serum alanine aminotransferase (ALT), twice the upper limits of normal (90 IU/L), and normal serum bilirubin were labelled as subclinical hepatitis.
  
  
  RESULTS
  A total of 360 children were evaluated for vague abdominal symptoms and 96 (26.7%) of them had hepatitis on laboratory profile. Eight patients developed early jaundice and were excluded from the study. Out of 88 (24.4%) cases of subclinical hepatitis, 82 (93.2%) had hepatitis-A, 03 (3.4%) had hepatitis-B, while no causative agent was found in 03 (3.4%) children. The common presenting symptoms were abdominal pain/discomfort, loss of appetite, nausea, vomiting, malaise, fatigue and fever. Hepatomegaly and splenomegaly was documented in 56% and 43% cases respectively. A history of exposure to a patient with hepatitis was present in 14/88 (15.9%) cases whereas no child was vaccinated against HAV. Serum ALT level declined to normal limits within 4 weeks for 77/88 (87.5%) cases and within 6 weeks for 84/88 (95.4%). All cases recovered spontaneously with out any complication.
  
  
  CONCLUSIONS
  Hepatitis-A was rampant in children presenting with vague abdominal symptoms in our series.
authors.affiliation: Department of Paediatrics, Combined Military Hospital, Peshawar.
authors.forename: Rahat
authors.initials: R
authors.lastname: Malik
authors.forename: Tariq
authors.initials: T
authors.lastname: Ghafoor
authors.forename: Muhammad
authors.initials: M
authors.lastname: Sarfraz
authors.forename: Najmul
authors.initials: N
authors.lastname: Hasan
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008111:Liver Function Tests; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D000410:Alanine Transaminase