| A Clinical and Pathologic Study on Chronic Hepatitis in Infancy and Childhood. |
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Ki Sub Jung1, Chan Ill Park2 |
1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea |
| 소아의 만성간염에 대한 임상적 및 조직학적 고찰 |
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정기섭1, 박찬일2 |
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 병리학교실 |
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| Abstract |
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A clinical and pathologic study was undertaken on 46 cases of chronic hepatitis who had been
admitted to Department of Pediatrics, Yonsei University College of Medicine during the period of 6
years from August, 1979 to July, 1985.
The results were as follows:
1) Of 46 patients with chronic hepatitis, 40 cases were caused by hepatitis B virus, 3 cases by
autoimmunity, and in 3 cases the cause was undetermined. Forty cases with chronic hepatitis B
corresponded to 8.1% of 496 patients with viral hepatitis B who had been admitted to the pediatric
ward during the period of 6 years for investigation.
2) Of 46 patients with chronic hepatitis, 8 cases (17%) had chronic lobular hepatitis, 21 cases (46%)
had chronic persistent hepatitis, and 17 cases (37%) had chronic active hepatitis including 6 cases of
liver cirrhosis.
3) A peak frequency of chronic hepatitis occurred between 1 to 6 years of age, and it is noteworthy
that 4 cases including 2 cases with chronic active hepatitis was under 1 year of age. The mean age
of patients was 6.5 ±3.6 years and did not differ statistically among the different histologic groups.
Males predominated in a proportion of 3.6: 1 for all patients with chronic hepatitis and 4.7: 1 for
chronic active hepatitis.
4) The clinical and laboratory findings did not significantly differ among the different histologic
groups. It is worthy to note that 18 (39%) of 46 patients with chronic hepatitis were found to have
HBsAg-positive reaction on routine testing prior to hepatitis B vaccination or surgery.
5) Eight patients with chronic lobular hepatitis were treated with conservative measures only: 5
cases showed normalized serum transaminase levels and 3 cases showed a loss of HBeAg and HBsAg.
Of 21 patients with chronic persistent hepatitis, 4 of 7 cases who were treated with vidarabine alone
or in combination with interferon showed normalized transaminase levels and a loss of HBeAg; 5 of
7 cases who were treated with conservative measures showed normalized transaminase levels, 2 cases
became HBeAg-negative and 1 case became HBsAg-negative; 2 of 5 cases received prednisolone alone
showed normalized transaminase levels without seroconversion of HBe or HBsAg.
Of 17 patients with chronic active hepatitis, 2 of 3 cases who were treated with vidarabine alone or
in combination with interferon showed normalized transaminase levels and 1 case showed a loss of
HBeAg; 7 of 10 cases who were treated with prednisolone alone showed normalized transaminase
levels, 1 case became seronegative for HBeAg and 3 cases became seronegative for HBsAg; 2 of 3
patients who were treated with prednisolone in combination with vidarabine showed normalized
transaminase levels without seroconversion of HBe or HBsAg.
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| Key Words:
Chronic hepatitis, Chronic lobular hepatitis, Chronic persistent hepatitis, Chronic active hepatitis.
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