Some peculiarities in the abnormal course of hepatitis A in childhood

Table 1 Clinical and laboratory characteristics in patients with hepatitis A (n = 115)

	Symptoms	n (%)
Clinical features of hepatitis A	Interval from symptom onset to hospital admission (days)	5.5 (2-9)
	Average length of hospitalization (days)	6.86 (5-18)
	Аverage time of pre icteric period (days)	4.3 (1-7)
Presenting symptoms (%)	General weakness	72
	Fever	52
	Jaundice	98
	Nausea/vomiting	73
	Аbdominal pain	44
	Diarrhea	18
Laboratory parameters	AST (IU/L), initial/peak level (normal range)	910/1350 (< 40)
	ALT (IU/L), initial/peak level (normal range)	1020/1410 (< 40)
	Bilirubin (mg/dL), initial/peak level (normal range)	3.4/6.8 (0.2-1.2)
	WBC (103/mm3), initial level (normal range)	6.1 (4-10)
	Hemoglobin (g/dL), initial level (normal range)	12.5 (12-16)
	Platelet (103/mm3), initial level (normal range)	166 (130-360)
Clinical outcomes	Typical course/recovery without complications	85 (73.91)
	Prolonged icteric period	11 (9.56)
	Acute acalculous cholecystitis	15 (13.04)
	Ascites	2 (1.73)
	Fulminant hepatitis, spontaneous recovery	1 (0.86)
	Thrombocytopenia	1 (0.86)

WBC: White blood cell; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.

Table 2 Comparisons of clinical and laboratory findings in patients with typical and atypical course of hepatitis A, n (%)

Parameter	Typical	Atypical	P value
Clinical manifestation	85 (73.9)	30 (26)	N/A
Mean age (years)	4.15	8.28	0.002
Males	42 (49.41)	16 (53.33)	N/A
Average length of hospitalization (days)	5.14 (3-7)	8.64 (5-18)	0.005
Fever	46 (54.11)	27 (90)	0.002
Nausea/vomiting	51 (60.0)	25 (83.33)	0.001
Pruritus	32 (37.64)	23 (76.66)	0.03
Аbdominal pain	40 (47.05)	17 (56.66)	NS
Diarrhea	13 (15.29)	8 (26.66)	0.02
Headache	28 (32.94)	15 (50)	0.005
AST (IU/L), peak level	1250	1640	0.01
ALT (IU/L), peak level	1035	2268	0.02
Bilirubin (mg/dL), peak level	3.4	8.9	0.02
WBCs (103/mm3), initial level	6.7	13.9	0.007
Hemoglobin (g/dL), initial level	11.4	8.9	NS
Platelet (103/mm3), initial level	155	148	NS

WBC: White blood cell; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; N/A: Not applicable; NS: Not significant.