Hepatitis in children caused by Hepatitis A virus is usually a self limiting disease. Hepatitis A presenting as hepatic encephalopathy or glomerulonephritis is rare. We are reporting two cases of children with Hepatitis A, one of whom presented with encephalopathy without fulminant hepatic failure and another developed acute glomerulonephritis. Both patients improved with conservative management. We describe these rare presentations of a common disease.

A nine year old female child presented with fever for eight days and abnormal behavior for one day. She was unable to recognize her parents, was biting and picking at objects and had decreased response to stimuli. Нere was no history of drug intake, toxin exposure or joint pain. Нere was no previous similar episode. Sibling had suوٴered from jaundice 15 days back. She was immunized as per national immunization schedule. On examination, the child was febrile (101.1°F), icteric and rest of the general examination was normal. Abdominal examination revealed mild hepatomegaly. Child was drowsy (stage II encephalopathy). Нere were no focal neurological deficLts tone and power were normal, deep tendon refle[es were brisk. Fundus examination was normal. A provisional diagnosis of hepatic encephalopathy was made. Her laboratory reports including complete blood count, blood glucose, serum electrolytes and renal function tests were within normal limits. Peripheral blood smear for malarial parasite and Widal test were negative. G6PD, Reticulocyte count and DCT were normal. Urine routine and microscopy.

Regards
Robert Har
Journal of Antivirals & Antiretrovirals