IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-1-17647 Original Research Paper Prolong cholestatic jaundice after Acute viral Hepatitis (HAV)? is corticosteroid beneficial Dr. Dr.A.Toppo Dr. Dr.A.K.Shadani Dr. January 2019 8 1 01 02 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.