Introduction
Case presentation
Laboratory analysis | Result |
---|---|
Hb | 11.7 g/dl |
WBC | 6.5 × 103 cells/mm3 |
PLT | 230 × 103/mm3 |
Serology HAV Igm | +ve HAV IgM −ve indirect Coombs |
PT | 14.4 (12.3 control) |
PTT | 25 (26 control) |
INR | 1.17 |
Albumin | 2.9 g/dl |
GGT | 101 U/l |
ALP | 410 IU/l |
Serum ammonia | 115 UG/dl |
Coombs test | Negative |
Liver biochemical markers tracing during hospital stay | 1st day | 2nd day | 3rd day |
---|---|---|---|
AST (U/l) | 470 | 396 | 300 |
ALT (U/l) | 883 | 654 | 578 |
Total bilirubin (mg/dl) | 8.9 | 4.1 | 4.1 |
Direct bilirubin (mg/dl) | 6.6 | 2.7 | 3 |
Discussion
Study | Sex | Age | Chief compliant | Physical examination | Management | Diuretics | Outcome |
---|---|---|---|---|---|---|---|
Saha [15] | M | 3 years | Generalized body swelling | Icterus, bilateral pitting edema, abdominal distention, hepatomegaly | Supportive management | N/A | Spontaneous resolution after 4 days |
Roy [16] Case 1 | F | 6 years | Fever, vomiting, fatigue | Icterus, abdominal distention, hepatomegaly, decreased breath sounds on the right side of chest | Supportive management, B-complex, ursodeoxycholic acid, oral lactulose | ++ | Spontaneous resolution after 1 week |
Roy [16] Case 2 | M | 4 years | Fever, jaundice | Abdominal distention, hepatomegaly | Supportive management | ++ | Spontaneous resolution |
Owen [17] | M | 42 years | Fever, malaise, pleuritic pain | Dullness on the base of right lung | Supportive management | N/A | Spontaneous resolution |
Dalai et al. [14] | F | 3 years | Fever, abdominal pain | Icterus, hepatomegaly | Supportive management, IV vit. K, oral antibiotic | N/A | Spontaneous resolution after 3 weeks |
Nagarajan et al. [18] Case 1 | F | 7 years | Abdominal pain, jaundice | Icterus, hepatomegaly, decreased breath sounds on the right side of chest | Supportive management | N/A | Spontaneous resolution after 3 weeks |
Nagarajan et al. [18] Case 2 | F | 10 years | Fever, vomiting, abdominal pain | Icterus, hepatomegaly | Supportive management | N/A | Spontaneous resolution |
Allen et al. [19] | F | 30 years | Flu like symptoms, fatigue, myalgia | Icterus, right upper quadrant abdominal tenderness | Supportive management | N/A | Spontaneous resolution |
Selimoğlu et al. [20] | M | 8 years | Fever, jaundice, anorexia, abdominal pain | Icterus, hepatomegaly, dullness on the base of right lung | Supportive management | N/A | Spontaneous resolution |
Mehta et al. [13] | M | 3 years | Fever, vomiting, abdominal pain, jaundice | Icterus, hepatomegaly, dullness on the base of right lung | Supportive management, IV amoxicillin–clavulanic acid, thoracotomy with chest tube insertion | N/A | Complete resolution after 1 week |
Alhan et al. [14] | M | 3 years | Fever, vomiting, jaundice | Febrile, icterus, hepatomegaly, dullness on the base of right lung | Supportive management | N/A | Death after 2 weeks due to fulminant liver failure, increased intracranial pressure |
Erdem et al. [10] | M | 12 years | Nausea, vomiting, fatigue | Icterus, febrile, hepatomegaly | Supportive management, vit. K, protein/lipid–restricted and carbohydrate-enriched diet | N/A | Spontaneous resolution after 10 days |
Ghosh and Kundu [12] | F | 4 years | Fever, jaundice, cough, dyspnea | Hepatomegaly, splenomegaly, abdominal distention, dullness on the base of right lung | Supportive management, IV vit. K, IV cefotaxime | N/A | Complete resolution after 1 week |
Gürkan et al. [10] | M | 4 years | Jaundice, abdominal pain, vomiting, headache | Jaundice, febrile, abdominal distention, hepatomegaly | Supportive management | N/A | Spontaneous resolution after 15 days |
Kaman et al. [21] | F | 4 years | Fever, fatigue, abdominal pain | Icterus, decreased breath sounds on the right side of chest | Supportive management, vit. K | N/A | Spontaneous resolution after 1 week |
Vaidya et al. [22] | F | 7 years | Vomiting, nausea | Icterus, hepatomegaly | Supportive management | N/A | Spontaneous resolution after 2 weeks |
Bukulmez et al. [23] | F | 7 years | Fever, jaundice, abdominal pain | Icterus, hepatomegaly, dullness on the base of right lung, abdominal distention | Supportive management | N/A | Spontaneous resolution after 2 week |
Dhakal et al. [5] | F | 2.5 years | Abdominal pain, scleral icterus | Icterus, hepatomegaly, dullness on the base of right lung | Supportive management | N/A | Spontaneous resolution after 2 week |
Hadgu et al. [24] | M | 4.8 years | Fever, abdominal pain, nausea and vomiting, cough | Bilateral dullness and decreased air entry, hepatomegaly, anicteric | Supportive treatment | N/A | Spontaneous resolution after 1 month |
Iza et al. [25] | F | 32 years | Jaundice epigastric pain, nausea, vomiting, dark urine | Icteric, abdominal tenderness, abdominal distension positive Murphy sign, decreased air entry on right chest | Supportive treatment | N/A | Spontaneous resolution after 4 months |
Study | Imaging finding | HAV serology | INR | Albumin (g/dl) | Total/direct bilirubin (mg/dl) | Pleural fluid analysis |
---|---|---|---|---|---|---|
Saha [15] | USG: bilateral pleural effusion, ascites CXR: left-sided pleural effusion | Serum anti-HAV IgM positive | N/A | 2.9 | 5.6/5 | NA |
Roy [16] Case 1 | USG: hepatomegaly, ascites, bilateral pleural effusion CXR: bilateral pleural effusion (right > left) | Serum and pleural fluid anti-HAV IgM positive | N/A | 3.4 | 2.6/1.4 | Total cell count 1500, glucose 99 mg/dl and protein 4.1 g/dl, negative culture |
Roy [16] Case 2 | USG: hepatomegaly, ascites, bilateral pleural effusion CXR: bilateral pleural effusion (right > left) | Serum anti-HAV IgM positive | N/A | 3.2 | 6.2/6.2 | NA |
Owen [17] | CXR: right pleural effusion | NA | N/A | N/A | N/A | NA |
Dalai et al. [14] | USG: right-sided pleural effusion, ascites, hepatomegaly | Serum anti-HAV IgM positive | 2 | N/A | 3.5/1.5 | NA |
Nagarajan et al. [17] Case 1 | USG: hepatomegaly, ascites, bilateral pleural effusion CXR: bilateral pleural effusion (right > left) | Serum and pleural fluid anti-HAV IgM positive | N/A | 2.5 | 5.4/4.8 | Total cell count 0, protein 20 g/dl |
Nagarajan et al. [17] case 2 | USG: hepatomegaly, bilateral pleural effusion, ascites CXR: bilateral pleural effusion | Serum anti-HAV IgM positive | N/A | 3.2 | 6.9/5.9 | NA |
Allen et al. [18] | USG: ascites, diffuse gallbladder wall thickening CT: ascites, right-side pleural effusion, gallbladder wall thickening | Serum anti-HAV IgM positive | N/A | 3.6 | 6/2.4 | NA |
Selimoğlu et al. [19] | USG: hepatomegaly CXR: right lower lung consolidation | Serum and pleural fluid anti-HAV IgM positive | 1.25 | 3.5 | 6/3.5 | Total cell count 0, glucose 70 mg/dl and protein 4.5 g/dl, negative culture |
Mehta et al. [13] | CXR: right-side pleural effusion | Serum and pleural fluid anti-HAV IgM positive | N/A | 2.8 | 5.3/5.2 | Total cell count 18200, glucose 94 mg/dl and protein 7.7 g/dl, negative culture |
Alhan et al. [14] | USG: hepatomegaly, right-side pleural effusion | Serum and pleural fluid anti-HAV IgM positive | N/A | 4.0 | 3.9/2.6 | Total cell count 0, transudate |
Erdem et al. [20] | USG: ascites, right-side pleural effusion, thickened gallbladder wall; CXR: right-sided pleural effusion | Serum and pleural fluid anti-HAV IgM, positive | 1.1 | 1.9 | 6.3/5.6 | Total cell count 0, transudate |
Ghosh and Kundu [12] | CXR: middle and lower zones of left lung opacity MRI: pleural effusion, hepatosplenomegaly, thickened gallbladder wall | Serum and pleural fluid anti-HAV IgM positive | 1.9 | N/A | 5.6/5.5 | Exudative pleural effusion |
Gürkan et al. [10] | USG: ascites CXR: bilateral pleural effusion | Serum anti-HAV IgM positive | N/A | 3.6 | 6/2.5 | NA |
Kaman et al. [10] | USG: ascites, pleural effusion CXR: right-side pleural effusion | Serum anti-HAV IgM positive | N/A | 2.5 | 6.6/4.8 | Glucose 90 mg/dl, negative culture |
Vaidya et al. [21] | USG: ascites, hepatomegaly, bilateral pleural effusion CXR: left-side pleural effusion | Serum anti-HAV IgM positive | 1.1 | 4 | 5.2/4.2 | NA |
Bukulmez et al. [22] | USG: hepatomegaly, right-side pleural effusion CT: right pleural effusion | Serum anti-HAV IgM positive | 1 | 3.3 | 8.2/6.7 | NA |
Dhakal et al. [5] | USG: ascites, bilateral pleural effusion CXR: right-side pleural effusion | Serum anti-HAV IgM positive | N/A | N/A | 5.8/4.5 | NA |
Hadgu et al. [24] | USG: mild ascites, hepatosplenomegaly, and small bilateral pleural effusion | Serum anti-HAV IgM positive | 1.5 | 3.8 | 1.5/0.5 | No cells, lactic acid dehydrogenase 15 IU/l, negative TB, negative bacterial culture |
Iza et al. [25] | USG: right pleural effusion, ascites and acalculous cholecystitis | Serum anti-HAV IgM positive | Normal | 3.5 | 2.6/2.5 | N/A |