Acute Hepatitis A Infection in Children: A 20-Year Experience of a Medical Center in Southern Taiwan

兒童急性A型肝炎：南台灣一醫學中心二十年之經驗

陳昱潔(Yu-Chieh Chen) ； 黃立同(Li-Tung Huang) ； 王盛民(Sheng-Ming Wang) ； 刁茂盟(Mao-Meng Tiao) ； 劉建衛(Jien-Wei Liu)

《Acta Paediatrica Taiwanica》 48卷3期 (2007/06) Pp. 131-134

https://doi.org/10.7097/APT.200706.0131

摘要

背景：台灣目前是A型肝炎非流行地區；然而，A型肝炎個案報告仍偶有所聞。兒童急性A型肝炎常以非特異性或腸胃道症狀來表現；因此，在非流行地區容易誤診為腸胃道疾病。
方法：此一回顧性研究，為南部一醫學中心1986至2004年兒童急性A型肝炎個案，包括29病童，其中16位男性及13位女性，加以分析其最常見的臨床表現、血液常規檢驗結果。
結果：胃口不好，倦怠，腹痛、嘔吐及發燒為最常見症狀；黃膽及茶色尿為最常見肝膽疾病相關的症狀，合併急速肝功能異常。本研究並無死亡病例報告；但過去二十年間，南部兒童急性A型肝炎的的盛行率有一逐漸上升的趨勢。
結論：本研究發現兒童急性A型肝炎常以腸胃道症狀及急速肝功能異常表現。肝功能指數的上升及鹼性磷酸酵素的異常合併黃膽為最常見的臨床表現。

關鍵字

急性A型肝炎 ； 兒童 ； 台灣

並列摘要

Background: Taiwan is currently nonendemic for hepatitis A infection, but sporadic cases are reported occasionally. The presenting symptoms of acute hepatitis A (AHA) infection in children are often nonspecific and may be easily misdiagnosed as general gastrointestinal illness.
Methods: We conducted this study to identify the relevant presenting symptoms and laboratory findings of AHA in children. The medical records of all patients younger than 18 years old admitted to Kaohsiung Chang Gang Memorial Hospital from July 1986 to June 2004 under the diagnosis of AHA were reviewed. There were 29 pediatric patients admitted with the diagnosis of AHA, including 16 male patients and 13 female patients.
Results: Poor appetite, malaise, abdominal pain, vomiting and fever were the leading constitutional symptoms. Jaundice and tea-colored urine were the most relevant hepatobiliary presentations. Elevation of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, direct and indirect bilirubin was common, although other hematology and biochemistry examinations were within normal limits on most occasions. There was no mortality in our series. A slightly increasing prevalence of AHA was noted over the two decades of the study period, although it was not statistically significant.
Conclusions: Our results found that children with AHA tended to present with non-specific gastrointestinal symptoms and acute liver function deterioration. Elevation of hepatic aminotransferase and alkaline phosphatase with cholestasis was common.

並列關鍵字

acute hepatitis A ； children ； Taiwan