Abstract:

Hepatit A is usually a self-limited, asymptomatic infection. However, severe manifestations of hepatitis may occur rarely in adult patients. Here, we present a case of prolonged, relapsed cholestasis secondary to acute hepatitis infection in an adult patient. A 25-year old male patient had been given symptomatic treatment for weakness, abdominal pain, loss of appetite, pruritis, nausea and generalized jaundice. A week later, he had been diagnosed with acute hepatitis A infection. He admitted to our clinic two months after the first episode with complaints of pruritis and jaundice. His laboratory results included a serum alanine aminotransferase (ALT) level of 86 U/L, aspartate transferase (AST) of 91 U/L, total bilirubin of 46.5 mg/dl and direct bilirubin of 33.9 mg/dl. ursodeoxycholic acid (UDCA) therapy was started due to protracted jaundice, severe itching and a marked elevation in bilirubin levels, which was replaced with prednisolone therapy at a dose of 1 mg/kg/day at 12 days. Most of his clinical symptoms resolved with much lower serum bilirubin levels. No clinical or biochemical deterioration was observed after discontinuation of therapy. One year later his general condition was good with no relapse. There are few case reports in literature about the use of corticosteroids for treat­ment of prolonged cholestatic jaundice in patients with hepatitis A infection. Based on our findings, we suggest that this type of therapy may be beneficial for relief of symptoms and improvement of serum biochemistry.

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