Chronic Hepatitis - Pediatric Oncall

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ISSN 0973 - 0958

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Question
I have a 2 year old daughter. Since she was 6 weeks old, her liver enzymes shoot up into the thousands every January. And no one knows why? They have done a liver biopsy on her, when she was 6 months old, but the only thing that came back on that was the kauffman cells were abnormal. She gets grey, lethargic and refuses oral in take. It starts off with vomiting projectile. No bowel movements, when she does have one its green and hard. I can supply reports, labs anything needed to find out what is wrong. Every test for hepatitis has come back negative, not much at all has come back positive, and as I said it only occurs in January. She gets hospitalized for a few days and then sent home. She does not get jaundice. As I mentioned her liver enzymes shoot up into the thousands. And GI doctor says its chronic viral hepatitis, and I just believe that it may be something else, but not sure what. I guess its mothers instinct. If you know what it is or may be please feel free to contact me thank you
Answer
Your child has a chronic hepatitis. The causes of chronic hepatitis are varied and includes infection, autoimmune disorder, drug toxicity and even metal related. If her workup for infection is negative, she needs to be worked up for autoimmune hepatitis and may be even a toxic screening. A dry copper weight and other heavy metals on the liver biopsy would be useful. An inborn error of metabolism such as tyrosinemia and even glycogen storage disorder should be ruled out. Back to All Questions

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