European Journal of Molecular & Clinical Medicine

Abstract

Aim: The aim of this study to determine the Presentation, etiology and viral markers in
children presenting with hepatitis at a Tertiary care hospital.
Methods: 50 cases of acute hepatitis of age 1-13yrs were included in the study. Acute
hepatitis was diagnosed on the basis of history, clinical (Jaundice, pain in upper
abdomen, anorexia, nausea, vomiting, fever, pruritis, tender/non tender hepatomegaly
with or without ascites and without any stigmata of chronic liver disease) and
biochemical evaluation (LFT i.e. serum bilirubin, Alanine
aminotransferase(ALT),Aspartate aminotransferase (AST),alkaline phosphatase(ALK),
serum albumin, PT/INR). Acute liver failure was diagnosed by PT>15sec/ INR>1.5 with
features of encephalopathy or PT > 20 sec/ INR > 2 regardless of presence of clinical
hepatic encephalopathy.. Patients were also tested for viral markers i.e. anti HAV IgM,
anti HEV IgM, HBsAg, and anti HCV.
Results: In our study total number of cases were 50 of which 70% were male and 30%
were female. The most common cause of viral hepatitis was hepatitis A (80%). Hepatitis
B was found in 2 (4%) cases and in 16% cases no viral marker was detected. The most
common clinical presentations were jaundice (96%), fever (94%), fatigue (90%) and
nausea/vomiting (78%). In 80% of cases hepatomegaly was found and splenomegaly
was seen in 2% of cases. SGPT level was increased in all cases with 30% in the range
500 – 1000 units/ml, 22% in the range of 1000 – 3000 units/ml and 12% in the range of
3000 – 5000 range. 48% of cases has total bilirubin of more than 10mg/dl and in 40% of
cases the value was in the range of 5 – 10 mg/dl. In 35cases PT was < 15sec and in 15
cases it was more than 15 sec. The disease resolved in 40(80%) cases,1(2%)had chronic
disease and 9(18%) cases expired.
Conclusions: Majority of cases in children were hepatitis A cases. Most of the cases
were Boys. Those cases with INR >3 at admission has higher mortality. Peak values of
aminotransferase i.e. ALT and AST though reflect hepatocyte damage do not correlate
with mortality.