Prolong cholestatic jaundice after Acute viral Hepatitis (HAV)? is corticosteroid beneficial

Dr.V.N.Mishra; Dr.S.Varma; Dr.A.Toppo; Dr.M.Patil; Dr.A.K.Shadani; Dr.Meena Patel

Volume : VIII, Issue : I, January - 2019

Prolong cholestatic jaundice after Acute viral Hepatitis (HAV)? is corticosteroid beneficial

Dr. V. N. Mishra, Dr. S. Varma, Dr. A. Toppo, Dr. M. Patil, Dr. A. K. Shadani, Dr. Meena Patel

Abstract :

Hepatitis A is usually a self–limited, asymptomatic infection. However, severe manifestations of hepatitis may occur rarely in adult patients.Severe cholestasis is one of the important causes of prolonged hospitalization in patients with acute hepatitis A. In such cases, higher chances of additional complications and increased medical costs are inevitable.

We present a case of prolonged cholestasis secondary to acute hepatitis infection (hepatitis A) in an adult patient who showed favorable responses to oral corticosteroids. A 21–year old male patient presented with complaints of weakness, abdominal pain, loss of appetite, nausea and yellowish discoloration of urine. A week later, he had been diagnosed with acute hepatitis A infection. He admitted to our hospital two months after the first episode with complaints of unresolved symptoms and intense pruritus which disturbed his sleep . His laboratory results included a serum (ALT) level of 385 U/L, (AST) of 395 U/L, total bilirubin of 29.4 mg/dl and direct bilirubin of 23.0 mg/dl. (UDCA) & cholestyramine,antihistaminics and supportive therapy was started due to protracted jaundice, severe itching and a marked elevation in bilirubin levels,subsequently prednisolone therapy at a dose of 1 mg/kg/day at day 70 started. Most of his clinical symptoms resolved with much lower serum bilirubin level. There are few case reports in literature about the use of corticosteroids for treatment of prolonged cholestatic jaundice in patients with hepatitis A infection.