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Prognostic Value of Porta-Hepatis Lymphadenopathy in Children with Hepatitis A
Amin Mashhadi1, Manijeh Khalili2, Alireza Ansari Moghaddam3
1Department of Radiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Insights
Porta-hepatis lymphadenopathy (PHL) and para-aortic lymphadenopathy do not significantly impact hepatitis A prognosis in children. However, ultrasound findings may indicate disease severity in pediatric hepatitis A patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Diagnostic Imaging
Background:
- Hepatitis A virus (HAV) infection is a common cause of acute liver inflammation in children.
- Porta-hepatis lymphadenopathy (PHL) is a potential ultrasound finding in HAV infection.
- The prognostic significance of PHL in pediatric HAV is not well-established.
Purpose of the Study:
- To investigate the prognostic value of porta-hepatis lymphadenopathy (PHL) in children diagnosed with hepatitis A virus (HAV).
- To assess the correlation between lymphadenopathy (porta-hepatis and para-aortic) and clinical outcomes in pediatric HAV patients.
Main Methods:
- A prospective cohort study included 123 pediatric patients with confirmed hepatitis A.
- Patients were grouped based on porta-hepatis lymph node size (>6 mm vs. <6 mm) and para-aortic lymphadenopathy presence.
- Laboratory results and hospital stay duration were compared between groups.
Main Results:
- Patients with larger porta-hepatis lymph nodes showed significantly higher liver enzyme levels (AST, ALT, ALP).
- Para-aortic lymphadenopathy was associated with elevated laboratory test results, excluding bilirubin.
- No significant correlation was found between the presence of porta-hepatis or para-aortic lymphadenopathy and patient prognosis.
Conclusions:
- Porta-hepatis lymphadenopathy and para-aortic lymphadenopathy do not appear to be significant prognostic indicators in pediatric hepatitis A.
- Abdominal ultrasound findings, including lymphadenopathy, may assist in evaluating disease severity in children with hepatitis A.
Background:
The present study aimed to investigate the prognostic value of porta-hepatis lymphadenopathy (PHL) in children with hepatitis A virus.
Methods:
The present prospective cohort study included 123 pediatric patients with a definite diagnosis of hepatitis A who were divided into two groups based on the presence or absence of PHL in their abdominal ultrasound: Group A included the patients with a porta-hepatis lymph node of >6 mm in diameter, whereas the patients with a porta-hepatis lymph node of <6 mm in diameter were classified in Group B. The patients were also classified based on the presence or absence of para-aortic lymphadenopathy: Group C had bisecting para-aortic lymph nodes, whereas Group D did not have such findings in their ultrasound. Afterward, the groups were compared in laboratory investigation results and hospital stay.
Results:
According to our results, Group A (n = 57) was significantly higher in aspartate and alanine aminotransferase and alkaline phosphatase levels compared to Group B (P < 0.05), whereas these two groups were not significantly different in the hospital stay. Furthermore, except bilirubin, all laboratory test results were significantly higher in Group C (n = 3) than in Group D. However, there was no significant correlation between the patients' prognosis with the absence or presence of porta-hepatis or para-aortic lymphadenopathy.
Conclusion:
We concluded that there was no significant relationship between porta-hepatis or para-aortic lymphadenopathy and the prognosis of the children with hepatitis A. However, ultrasound findings can help determine the disease severity in pediatric patients with hepatitis A.
