背景:急性甲型肝炎感染在发展中国家的儿童中很常见。儿童的临床表现通常是无症状和黄疸,这是一种自限性感染。很少,它可能与胸腔积液等肝外并发症有关,无结石性胆囊炎,和腹水。
方法:一名8岁的中东儿童出现腹痛,巩膜黄疸,尿液的黄色,食欲不振。在过去的两天里,腹胀。在进行诊断调查后,患儿被诊断为伴有双侧胸腔积液的HAV肝炎,无结石性胆囊炎,和腹水。他接受了补充维生素K和支持性肠胃外液体的保守治疗。4天后,观察到临床改善。
结论:甲型肝炎感染表现为肝外表现,如胸腔积液,无结石性胆囊炎,腹水非常罕见,尤其是儿童。有一些报道称这些表现是孤立发生的,但是为了让他们根据我们的知识共存,这只在文献中报道了两个案例,这是第三种情况,所有这三种罕见的并发症同时出现在一个孩子身上。尽管HAV感染在儿童时期是一种无症状和自限性的病毒性疾病,它可以表现为罕见的肝外并发症,所以儿科医生应该意识到这种罕见的关联,以避免不必要的调查。
BACKGROUND: Acute hepatitis A infection is common among children in developing nations. The clinical presentation in children is usually asymptomatic and anicteric, and it is a self-limiting infection. Rarely, it can be associated with extrahepatic complications such as pleural effusion, acalculous cholecystitis, and ascites.
METHODS: An 8-year-old middle eastern child presented with abdominal pain, jaundice in the sclera, yellowish color of urine, and poor appetite. In the last two days, abdominal distension developed. After conducting diagnostic investigations, the child was diagnosed with HAV hepatitis associated with bilateral pleural effusion, acalculous cholecystitis, and ascites. He was managed conservatively with vitamin K supplementation and supportive parenteral fluids. After 4 days, clinical improvement was observed.
CONCLUSIONS: Hepatitis A infections presented with extrahepatic manifestations like pleural effusion, acalculous cholecystitis, and ascites are very rare, especially in children. There have been some
reports of these manifestations occurring in isolation, but for them to co-exist to our knowledge, this has only been reported in two cases in the literature, and this is the third
case with all these three rare complications being presented simultaneously in a single child. Although HAV infection is an asymptomatic and self-limiting viral disease in childhood, it can manifest with rare extrahepatic complications, so pediatricians should be aware of this rare association to avoid unnecessary investigations.