Clinical and Laboratory Profile of Acute Viral Hepatitis in Children- A Prospective Observational Study

Abstract

Acute viral hepatitis is a systemic infection which affects the liver predominantly.It is  a common medical problem in children in developing countries like India. This disorder is caused by atleast five pathognomic hepatotropic viruses and many other nonhepatotropicviruses.Commonhepatotropic viruses are  hepatitis A, B, C, D and E (HAV, HBV, HCV, HDV and HEV ) respectively. The clinical spectrum of acute viral hepatitis  can range from entirely subclinical and inapparent infection to rapidly progressing and fulminant hepatic failure.Our study was conducted to determine the clinical and laboratory profile of acute  viral hepatitis in children.57 children admitted in the Department of Pediatrics, IMS & SUM Hospital, Bhubaneswarwith confirmed viral hepatitis from August 2017 to Aug 2019 were included. Data including age, sex, clinical presentation and laboratory investigations were collected and analysed.57children consisting of 33 males and 24 females were enrolled in the present study. The mean age of admitted patients was 8.9 years. Most common presenting symptoms were yellowish discoloration of eyes, abdominal pain, nausea, vomiting,fever, fatigue, loss of appetite and pruritus. Most common signs were icterus followed by tender hepatomegaly and pallor. Viral marker study suggested that hepatitis A was the most common virus. Hepatic encephalopathy was observed in 3 patients. All patients were managed conservatively, and most patients were discharged in satisfactory condition. In spite of our best efforts, 2children expired.Majority of children were suffering from hepatitis A , followed by hepatitis   E.Most common presenting symptom was yellowish discoloration of eye and most common signs was icterus. Children with elevated liver enzymes (SGOT >3000) and PT /INR >3 at the time of admission had higher mortality.