title: Hepatitis A in children- clinical course, complications and laboratory profile.
abstract: OBJECTIVE
  To study the course and complications of hepatitis A in children.
  
  
  METHODS
  Seventy eight children diagnosed as acute viral hepatitis A by IgM antiHAV were prospectively studied for involvement of other systems and complications.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, JSS Medical College, JSS University, Mysore, Karnataka, India, jagdishmandya@gmail.com.
authors.forename: K Jagadish
authors.initials: KJ
authors.lastname: Kumar
authors.forename: H C Krishna
authors.initials: HC
authors.lastname: Kumar
authors.forename: V G
authors.initials: VG
authors.lastname: Manjunath
authors.forename: C
authors.initials: C
authors.lastname: Anitha
authors.forename: S
authors.initials: S
authors.lastname: Mamatha
mesh_terms: D002648:Child; D006506:Hepatitis A / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D011446:Prospective Studies
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