Prolonged cholestasis due to hepatitis A virus infection in a young adolescent male with a known case of hemoglobin E disease: early response to steroid therapy

Abstract

Background: Acute hepatitis due to hepatitis A virus infection is a self-limiting mild disease. Sometimes, it may have an atypical course in few percentages. We reviewed with characteristics, response to steroid therapy, and outcome of prolonged cholestatic jaundice in hepatitis A virus infection. Case summary: We analyzed acute hepatitis with a prolonged cholestatic course due to hepatitis A virus infection in an adolescent with preexisting hemoglobin E disease. Bilirubin was gradually increasing, the maximum total bilirubin was 48.3 mg/dl, and direct 46.6 mg/dl at day 50 of symptoms onset. After that, the steroid was started along with ursodeoxycholic acid. The patient gradually improved clinically and biochemically. Conclusion: Hepatitis A virus infection may cause prolonged cholestatic severe jaundice in a patient with preexisting congenital hemolytic disease. Steroid therapy may induce early recovery.