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954 Pleural Effusion and Ascites: An Unusual Complication of Hepatitis A
  1. TI El-Azzabi,
  2. V Malpani
  1. Paediatrics, Child Health Institute, Al Ain Hospital, Al Ain, United Arab Emirates

Abstract

Background and Aims To the best of our knowledge, we are reporting the first case from United Arab Emirates in the literature of Hepatitis A associated with pleural effusion and ascites. Hepatitis A is the most common cause of viral hepatitis in childhood and a major health problem in the developing world. Pleural effusion and ascites are very rare extrahepatic complications of hepatitis A. There have been only a few case reports in the literature of the two complications. The etiology is not clearly understood, but they tend to undergo spontaneous resolution and do not warrant specific diagnostic or therapeutic measures.

Methods Information collected from the hospital electronic case notes (Cerner).

Results Our case is a three years old Afghani boy who presented with fever and jaundice for two days. There was no history of recent travel abroad. Investigations revealed a high DIRECT bilirubin level and elevated liver enzymes. Hepatitis A virus immunoglobulin M (HAV IgM) was detected. During the course of hepatitis A, the child developed clinically significant and symptomatic bilateral pleural effusion associated with ascites. The diagnosis was confirmed with chest x-ray and ultrasonography. Lowest Albumin level was 23 g/l. Both pleural effusion and ascites resolved spontaneously without intervention.

Conclusions In patients with jaundice and pleural effusion and/or ascites, Hepatitis A is an important differential diagnosis. Both conditions are self-limited. Pleural and/or peritoneal diagnostic tapping is not warranted. Research is required to explore the underlying pathogenesis of the association.

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