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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2022; 14(5): 944-955
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.944
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.944
Pediatric acute viral hepatitis with atypical variants: Clinical dilemmas and natural history
Moinak Sen Sarma, Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Aathira Ravindranath, Division of Pediatric Gastroenterology, Apollo BGS Hospitals, Mysuru 570023, Karnataka, India
Author contributions: Sarma MS contributed the supervision and critical review of final draft of the manuscript; Ravindranath A contributed the literature search, data collection and writing first draft of manuscript; both authors wrote, read and approved the final manuscript.
Conflict-of-interest statement: Both authors have no conflicts of interests to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Moinak Sen Sarma, MD, Associate Professor, Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India. moinaksen@gmail.com
Received: January 6, 2022
Peer-review started: January 6, 2022
First decision: February 8, 2022
Revised: February 20, 2022
Accepted: May 5, 2022
Article in press: May 5, 2022
Published online: May 27, 2022
Peer-review started: January 6, 2022
First decision: February 8, 2022
Revised: February 20, 2022
Accepted: May 5, 2022
Article in press: May 5, 2022
Published online: May 27, 2022
Core Tip
Core tip: Acute viral hepatitis (AVH) in children can manifest with atypical features in about a quarter of children. The most common entities, such as prolonged cholestasis and relapsing hepatitis, cause liver dysfunction and are often confused with chronic liver diseases (CLDs). Similarly, ascitic form of AVH and late-onset hepatic failure are close differential diagnoses of acute-on-chronic liver failure and decompensated CLD. A combination of a thorough history, clinical findings, basic investigations and outcome on follow-up allows focused workup and management in atypical AVH.