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Prolonged cholestasis due to hepatitis A virus infection

Pawan Kumar1, Vidyut Bhatia

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110 029, India.

Indian Pediatrics
|July 12, 2011
PubMed

Insights

A pediatric case of prolonged cholestasis due to Hepatitis A virus infection showed limited response to cholestyramine but improved with prednisolone treatment.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Hepatitis A virus (HAV) infection typically presents with acute hepatitis.
  • Prolonged cholestasis is an uncommon manifestation of HAV infection in children.
  • Standard treatment for cholestasis often involves bile acid sequestrants.

Observation:

  • A 12-year-old boy presented with a 2-week history of jaundice, icterus, and hepatomegaly.
  • Initial investigations revealed positive IgM antibodies for Hepatitis A virus.
  • The patient exhibited prolonged cholestasis unresponsive to cholestyramine therapy.

Findings:

  • The cholestatic jaundice persisted despite cholestyramine administration.
  • Introduction of prednisolone led to a significant clinical improvement.
  • This suggests a potential role for corticosteroids in managing refractory cholestasis in HAV infection.

Implications:

  • This case highlights an atypical presentation of Hepatitis A virus infection.
  • It underscores the importance of considering alternative treatment strategies for prolonged cholestasis.
  • Further research may elucidate the mechanisms behind steroid responsiveness in such cases.

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