Pediatric Hepatitis Flashcards
List the causes that can lead in Hepatitis in children.
A) Toxins/drugs:
■ Paracetamol overdose is #1 cause of fulminant hepatitis. Give Nacetylcysteine
to replenish glutathione stores, reduce toxic metabolites.
■ Reye’s syndrome: due to aspirin use in viral illnesses. Acute liver
failure with encephalopathy. Supportive tx.
B) Viral:
■ Hepatitis A: fecal-oral transmission, never chronic
● Who should get hep A vaccine: immunosuppressed, congenital
liver disease, travelers to affected regions
■ Hepatitis B: usually vertical transmission during childbirth
● Likely to become chronic but milder/less inflammatory
response than in adult infections.
● Tx: lamivudine + interferon alpha
● Chronic HBV: consequence is HCC
● Give vaccine around age 12, requires 3 doses. Develop Ab to
HbS
■ Hepatitis C: possible from maternal transfer. Usually chronic. Curable
with new antivirals.
■ Other: EBV, yellow fever, dengue, adenovirus, parvovirus, herpes
simplex
C) Autoimmune:
■ Type I: more common. Predominantly adolescent girls.
■ Type II: more frequent in younger ages, equal gender distribution,
more severe acutely,
■ Tx requires immunosuppression.
