Rare presentation of hepatitis A with ascites, pleural effusion and acalculous cholecystitis

Deepty Nauriyal; Kapil  Raote; Rishabh  Dubey; Ajay Punj

doi:10.18203/2349-3291.ijcp20242026

Authors

Deepty Nauriyal Department of Pediatrics, Subharti Medical College, Meerut, Uttar Pradesh, India
Kapil Raote Department of Pediatrics, Subharti Medical College, Meerut, Uttar Pradesh, India https://orcid.org/0009-0008-7786-2588
Rishabh Dubey Department of Pediatrics, Subharti Medical College, Meerut, Uttar Pradesh, India https://orcid.org/0009-0007-8312-4023
Ajay Punj Department of Pediatrics, Subharti Medical College, Meerut, Uttar Pradesh, India https://orcid.org/0000-0002-5650-1598

DOI:

https://doi.org/10.18203/2349-3291.ijcp20242026

Keywords:

Acalculous cholecystitis, Ascites, Hepatitis A virus, Pediatrics, Pleural effusion

Abstract

Hepatitis A is an important health problem in developing and under-developed countries, including India. Mostly it has a self-limiting course. Extra-hepatic manifestations in form of ascites, pleural effusion and acute acalculous cholecystitis occurring in same patient are not commonly reported. We report a recent case of 8-year-old boy with ascites, right sided pleural effusion and acalculous cholecystitis. Child presented to us with jaundice, pain abdomen and difficulty in breathing. His serology was positive for hepatitis A. He was successfully managed with conservative treatment. No antibiotics were started and no invasive procedures were carried out. Ascites, pleural effusion and acalculous cholecystitis, are rare presentation of hepatitis A that have self-limiting course and don’t affect severity of disease. Physicians should be aware of this rare presentation, so that invasive procedures, unnecessary investigations and undue anxiety of treating doctors and parents could be avoided.

Metrics

Metrics Loading ...

References

Rao A, Wanjari MB, Prasad R, Munjewar PK, Sharma R. From Mystery to Clarity: Uncovering the Possible Cause of Hepatitis Outbreak in Children. Cureus. 2023;15(5):e38388.

Alam R, Karim ASMB, Mazumder MW, Das SR, Benzamin M, Sonia ZF, et al. Atypical manifestations of acute viral hepatitis A in children in Bangladesh: Are these really uncommon? Indian J Gastroenterol. 2021;40:470-6.

Gross PA, Gerding DN. Pleural effusion associated with viral hepatitis. Gastroenterology. 1971;60(5):898-902.

Zalloum JS, Alzughayyar TZ, Abunejma FM, Mayadma I, Tomeh LZ, Abulaila KJ. Acute benign pleural effusion, a rare presentation of hepatitis A virus: a case report and review of the literature. J Med Case Rep. 2022;16(1):231.

Mehta K, Shinde S, Rego S, Shet A. Hepatitis A Associated with Chylothorax: An Uncommon Presentation of a Common Infection. J Trop Pediatr. 2015;61(6):468-73.

Dalai R, Malhotra S, Gupta AK, Mandal M, Kant S. A rare case of childhood Hepatitis A infection with pleural effusion, acalculous cholecystitis, and ascites. J Family Med Prim Care. 2018;7(6):1581-3.

Ranjum, Nanda N, Sehgal N, Saini SK, Gahlot V, Anigani K, et al. A Rare Case of Childhood Hepatitis A Infection with Bilateral Pleural Effusion Acalculous Cholecystitis and Massive Ascites. J Pediatr Perinatol Child Health. 2023;7:21-3.

Erdem E, Urgancı N, Ceylan Y, Kara N, Ozcelik G, Gulec SG. Hepatitis A with pleural effusion, ascites and acalculous cholecystitis. Iran J Pediatr. 2010;20(4):479-82.

Das A, Ahmed S, Medhi S, Kar P. Changing patterns of aetiology of acute sporadic viral hepatitis in India-newer insights from North-East India. Int J Cur Res Rev. 2014;19:14-2.

Foster MA, Haber P, Nelson NP. Hepatitis A. Epidemiology of Vaccine Preventable Diseases. CDC. 2018. Available at: https://www.cdc.gov/vaccines/pubs/pinkbook/hepa.html. Accessed on 12 March 2024.

Goyal S, Kumar S, Anand S, Tiwari A. Hepatitis A infection: an unusual cause of pleural effusion. Pediatr Oncall J. 2015;12:48-9.

Dhakal AK, Shakya A, Shrestha D, Shah SC, Shakya H. An unusual association of pleural effusion with acute viral hepatitis A infection. Pediatric Health Med Ther. 2014;5:149-53.

Kurt A, Bulut Y, Turgut M, Akarsu S, Yilmaz E, Poyrazoğlu HG, et al. Pleural effusion associated with hepatitis A. J Pediatr Inf. 2008;2(1):25-6.

Salajegheh F, Shafieipour S, Najminejad Z, Pourzand P, Nakhaie M, Jahangiri S, et al. HAV-induced acalculous cholecystitis: A case report and literature review. Clin Case Rep. 2023;11(4):e7254.

Mourani S, Dobbs S, Genta RM, Tandon AK, Yoffe B. Hepatitis-A-virus associated cholecystitis. Ann Intern Med. 1994;120(5):398-400.