Yılmaz-Çiftdoğan D, Köse E, Aslan S, Gayyurhan E. Atypical clinical manifestations of hepatitis A among children aged 1-16 years in South-Eastern region of Turkey. Turk J Pediatr 2015; 57: 339-344. Hepatitis A virus (HAV) infection has several atypical manifestations, including fulminant hepatitis, relapsing hepatitis, prolonged cholestasis and extrahepatic manifestations. In this study, we aimed to describe the characteristics and outcomes of the pediatric patients with atypical manifestations of HAV infection. Four hundred twelve children with symptomatic hepatitis A infection admitted to Gaziantep Children`s Hospital Department of Pediatric Infectious Disease between August 2011 and January 2013 were analyzed retrospectively. Atypical presentations were present in 53 (12.8%) children of 412 children with HAV infection. Patients with atypical presentations (8.3±3.7 years) were older than patients with typical presentations (5.9±3.1 years) (p=0.001). Children with atypical features of hepatitis A statistically had higher initial and peak values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), international normalized ratio (INR), serum total and direct bilirubin than typical manifested group. We can conclude that older age is the major risk factor for atypical presentation of HAV infections. Higher initial and peak levels of AST, ALT, INR, total and direct bilirubin could predict the atypical manifestation.

Keywords: atypical, child, hepatitis A