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Published on: November 27, 2019
[Hepatitis A - combined prolonged biphasic and cholestatic course of disease]
L Schmidt1, R Zachoval, H Diepolder
1Medizinische Klinik und Poliklinik II, Klinikum Großhadern, Ludwig-Maximilians-Universität München. Laura.Schmidt@med.uni-muenchen.de
History And Admission Findings:
One month after a first manifestation of a hepatitis A infection and transaminases had become normal, a 44-year-old woman again became jaundiced with accompanied by weakness, nausea and nocturnal sweating.
Investigations:
Laboratory tests again showed features of hepatitis with decreased synthetic liver function and hyperbilirubinemia, changes which persisted for 12 weeks. Serological and virological studies revealed a positive test for anti-hepatitis A virus (HAV) IgM and HAV-RNA was detected in the stool.
Diagnosis, Treatment And Course:
These tests demonstrated two rare features of hepatitis A, namely a prolonged biphasic course combined with cholestasis form. In addition a hemolytic anaemia developed.
Conclusion:
The severity of a relapse of hepatitis A varies: in this case it was more severe than the initial manifestation. The reasons for the different courses of hepatitis A infection remain unclear.
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