Chronic hepatitis
Author: Pediatric Oncall
Question.
A 2½ years old boy presented in Jan 2009 with incidentally detected hepatomegaly. There was no jaundice, fever or vomiting. On examination, weight was 12 kg, height was 85.8 cm and there was hepatomegaly {9 cm span}. Other systems were normal. Liver function tests are depicted in Table 1. His Hepatitis A IgM, HBsAg, Hepatitis E IgM, Hepatitis C ELISA were negative. His liver enzymes continued to be elevated for next 6 months. Autoimmune markers are depicted in Table 1. His 24 hrs urine copper are also depicted in Table 1. Her serum alpha fetoprotein and alpha 1 antitrypsin levels were normal. Liver biopsy showed mild early fibrosis with liver copper content of 21.2 µg, gm. Hepatocytes were PAS positive. In Nov 2009 in view of positive anti smooth muscle antibody, he was started on oral steroids to which his liver enzymes decreased in April 2010. His anti smooth antibody became negative in Feb 2010. In June 2011, he again had elevated liver enzymes which increased markedly in Nov 2011. His serum IgG was 8.78 gm, dl and liver biopsy showed same amount fibrosis without interface hepatitis. His antibodies to ANA, smooth muscle, LKM were negative.
Answers of this discussion
Author :- asuwaidicas on 13 September 2012.
Answer :- Wells disease

Author :- Pravin G Patel on 13 September 2012.
Answer :- Glycogen storage disorder should be ruled in or out.Autoimmune hepatitis should also be kept in mind

Author :- hanan mohamed on 14 September 2012.
Answer :- wilson disease

Author :- hanan mohamed on 14 September 2012.
Answer :- wilson disease

Author :- rajeevcash on 14 September 2012.
Answer :- autoimmune hepatitis

Author :- NEVIN ALIca on 15 September 2012.
Answer :- Wilson`s Disease. KF ring is not expected to be found at this age. If it is found, it is usually accompanied by neurological signs and symptoms of wilson`s disease.

Author :- Colin Powell on 15 September 2012.
Answer :- wilsons disease

Author :- houwayda alhagi on 15 September 2012.
Answer :- auto immune hepatitis

Author :- ABDULHAKIM ABDURRAAQ on 15 September 2012.
Answer :- indian childhood cirrhosis

Author :- Lloydetta Michelle Stovall on 16 September 2012.
Answer :- wilson disease

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