All issues > Volume 30(1); 1987

Original Article

J Korean Pediatr Soc. 1987;30(1):35-44. Published online January 31, 1987.

A Clinical and Pathologic Study on Chronic Hepatitis in Infancy and Childhood.

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

Abstract

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.

Keywords :Chronic hepatitis, Chronic lobular hepatitis, Chronic persistent hepatitis, Chronic active hepatitis.