Prolonged cholestatic jaundice with very high bilirubin level due to hepatitis e infection

  • Authors

    • Devki Nandan PGIMER,Dr.RML Hospital New Delhi-110001
    • Manish Kumar PGIMER,Dr.RML Hospital New Delhi-110001
    • Vivek Dewan PGIMER,Dr.RML Hospital New Delhi-110001
    • Chinmaya Sahoo PGIMER,Dr.RML Hospital New Delhi-110001
    2014-04-24
    https://doi.org/10.14419/ijbas.v3i2.2269

  • Abstract

    A 12 year old male child presented with jaundice, generalized itching and disturbed sleep of one and half months duration. Extremely high Serum bilirubin levels (total 38.3 mg/dl, direct 27mg/dl, and indirect 11mg/dl) with normal liver enzymes were documented, which gradually resolved over next two months on supportive management. Hepatitis E infection was diagnosed based on presence of positive Anti hepatitis E IgM antibodies. Underlying associated hepato-biliary diseases were ruled out on a detailed work-up of the case. This case is a unique example of prolonged cholestatic jaundice with extremely high levels of bilirubin with normal liver enzymes in a case of hepatitis E, which has not been reported   previously in pediatric age group.

     

    Keywords: high bilirubin, hepatitis E, Cholestatic jaundice, normal liver enzyme, prolonged jaundice.

  • References

    1. Mast EE, Krawczynski K. Hepatitis E: An Overview. Annu Rev Med 1996:47: 257–66.
    2. Vishwanathan R, Sidhu AS. Infectious Hepatitis: Clinical Finding. Indian J Med. Res 1957; 45(Suppl): 49-58.
    3. Zhuang H, Cao X-Y, Liu C-B, Wang G-M. Enterically Transmitted None A Non B Hepatitis In Cina. In: Shikata T, Purcell RH, Uhida T, Eds. Viral Hepatitis C, D And E. Amsterdam : Excerpta Medica, 1991;277-85
    4. Wong DC, Purcell RH, Sreenivasan MA, Et Al. Epidemic and Endemic Hepatitis in India: Evidence For Non-A, Non-B Hepatitis Virus Etiology. Lancet 1980; 2: 876–9.
    5. Chauhan A, Jameel S, Dilawari J Et Al. Hepatitis E Virus Transmission to A Volunteer. Lancet 1993; 1:149–50.
    6. Karetnyi YV, Favorov MO, Khudyakova NS, Et Al. Serological Evidence for Hepatitis E Virus Infection in Israel. J Med Virol 1995; 45:316–20.
    7. Terrault NA, Wright TL. Viral Hepatitis A through G. In: Feldman M, Scharschmidt BF, Sleisenger MH, Eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management, 6th Ed. Philadelphia: WB Saunders Co, 1998:1123–70.
    8. Vento S, Garofano T, Di Perri G, Et Al. Identification of Hepatitis A Virus as a Trigger for Autoimmune Chronic Hepatitis Type 1 in Susceptible Individuals. Lancet 1991; 337:1183–7.
    9. Sylvan SPE, Hellstrom UB, Hampl H, Et Al. Hepatitis E in Patients with Chronic Autoimmune Liver Disease. JAMA 1995; 273:377–8.
    10. Chow WC, Lee ASG, Lim GK, Et Al. Acute Viral Hepatitis E: Clinical and Serological Studies in Singapore. J Clin Gastroenterol 1997; 24:235.
    11. Spectrum Of Hepatitis E Virus Infection In India Mohammed Sultan Khuroo, Vinod K. Rustgi, George J. Dawson, Isa K. Mushahwar, Ghulam Nabi Yattoo, Saleem Kamili, and Bashir Ahmad Khan, Journal Of Medical Virology 43:281-286 (1994).
    12. 12. Laura Mechnik, M.D., Nina Bergman, M.D., Malka Attali, M.D.Et Al. Acute Hepatitis E Virus Infection Presenting As A Prolonged Cholestatic Jaundice. J Clin Gastroenterol 2001; 33(5):421–422.

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  • How to Cite

    Nandan, D., Kumar, M., Dewan, V., & Sahoo, C. (2014). Prolonged cholestatic jaundice with very high bilirubin level due to hepatitis e infection. International Journal of Basic and Applied Sciences, 3(2), 99-100. https://doi.org/10.14419/ijbas.v3i2.2269

    Received date: 2014-03-21

    Accepted date: 2014-04-17

    Published date: 2014-04-24