Çetinkaya Bilge, Tezer Hasan, Özkaya Parlakay Aslinur, Revide Sayli Tulin
Ankara Hematology Oncology Children's Training and Research Hospital, Ankara, Turkey.
J Infect Dev Ctries. 2014 Mar 13;8(3):326-30. doi: 10.3855/jidc.4057.
Hepatitis A is the most common form of acute viral hepatitis worldwide, especially in children. The clinical severity of the hepatitis A virus (HAV) infection varies from an asymptomatic infection to a fulminant disease. In this study, we aimed to evaluate characteristics of pediatric patients diagnosed with HAV infection.
Patients younger than 18 years of age admitted between January 1, 2006 and January 1, 2011 to our hospital, an important reference center located in the middle part of Turkey, diagnosed as having hepatitis A were evaluated.
Of 427 patients, 49.4% were female and 50.6% were male. Hospitalization rate of the patients was 28.3%. The reason for hospitalization was vomitting in 58.7% of the patients and abdominal pain in 28%. The mean time of hospitalization was 5.2 ± 4.5 (1-40) days. There was no significant difference in hospitalization time by age. Vomiting and abdominal pain were significantly more common, and PT and aPTT levels were significantly elevated in patients with elevated AST and ALT levels over 1000 IU/L (p < 0.001). PT elevation was present in 15.2% of the patients, aPTT elevation in 11.9%, leukopenia in 16.6%, and thrombocytopenia in 2.6%. In terms of atypical course, four patients (0.9%) had cholestatic hepatitis, one had recurrent hepatitis, and one had fulminant hepatitis, yet no mortality was observed.
Atypical courses of hepatitis A were more scarce in pediatric patients, but careful follow-up of patients with AST and ALT levels > 1000 IU/L is necessary.
甲型肝炎是全球最常见的急性病毒性肝炎形式，尤其是在儿童中。甲型肝炎病毒（HAV）感染的临床严重程度从无症状感染到暴发性疾病不等。在本研究中，我们旨在评估被诊断为HAV感染的儿科患者的特征。
对2006年1月1日至2011年1月1日期间入住我院（位于土耳其中部的一个重要参考中心）的18岁以下被诊断为甲型肝炎的患者进行评估。
427例患者中，49.4%为女性，50.6%为男性。患者的住院率为28.3%。住院原因中，58.7%的患者是呕吐，28%是腹痛。平均住院时间为5.2±4.5（1 - 40）天。住院时间按年龄无显著差异。AST和ALT水平超过1000 IU/L的患者中，呕吐和腹痛明显更常见，PT和aPTT水平显著升高（p < 0.001）。15.2%的患者出现PT升高，11.9%出现aPTT升高，16.6%出现白细胞减少，2.6%出现血小板减少。在非典型病程方面，4例患者（0.9%）患有胆汁淤积性肝炎，1例患有复发性肝炎，1例患有暴发性肝炎，但未观察到死亡病例。
甲型肝炎的非典型病程在儿科患者中较为少见，但对于AST和ALT水平>1000 IU/L的患者进行仔细随访是必要的。
