Hepatitis A - frequency in children with non-specific abdominal symptoms

ABSTRACT

To study the frequency of subclinical hepatitis 'A' in children having non-specific abdominal symptoms. Design: A descriptive study. Place and Duration of Study This study was conducted at Combined Military Hospital [CMH], Peshawar from June to December 2000. Subjects and Three hundred and sixty children of either gender, < 12 years of age, presenting with vague abdominal symptoms and no jaundice were evaluated for hepatitis. Eighty eight [24.4%] children meeting the inclusion criteria of elevated serum alanine aminotransferase [ALT], twice the upper limits of normal [90 IU/L], and normal serum bilirubin were labelled as subclinical hepatitis. A total of 360 children were evaluated for vague abdominal symptoms and 96 [26.7%] of them had hepatitis on laboratory profile. Eight patients developed early jaundice and were excluded from the study. Out of 88 [24.4%] cases of subclinical hepatitis, 82 [93.2%] had hepatitis-A, 03 [3.4%] had hepatitis-B, while no causative agent was found in 03 [3.4%] children. The common presenting symptoms were abdominal pain/discomfort, loss of appetite, nausea, vomiting, malaise, fatigue and fever. Hepatomegaly and splenomegaly was documented in 56% and 43% cases respectively. A history of exposure to a patient with hepatitis was present in 14/88 [15.9%] cases whereas no child was vaccinated against HAV. Serum ALT level declined to normal limits within 4 weeks for 77/88 [87.5%] cases and within 6 weeks for 84/88 [95.4%]. All cases recovered spontaneously with out any complication. Hepatitis-A was rampant in children presenting with vague abdominal symptoms in our series