Hepatitis A Associated with Chylothorax: An Uncommon Presentation of a Common Infection

An uncommon presentation of Hepatitis A Virus (HAV) Infection is cutaneous vasculitis. This report is about a seven-year-old male patient that came to the pediatric emergency with complaints of bilateral swelling of lower limbs and pain in right knee for the last three days. Patient had history of jaundice one month back. On examination, he was febrile and had swelling over right knee with decreased range of movements and multiple palpable purpura over lower extremities and buttocks. Laboratory evaluation showed deranged Liver Function Test (LFT) and positive HAV IgM antibodies. Histopathological examination of skin biopsy was suggestive of leukocytoclastic vasculitis and IgA deposition. Final diagnosis of Henoch Schonlein Purpura (HSP) was established based on clinical findings and skin biopsy findings which are usually sufficient for confirmed diagnosis. Patient was admitted and managed conservatively with oral analgesics. After a few days, patient was discharged in satisfactory condition.

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Alcoholic Hepatitis: A Common Disease with Uncommon Presentation

Case Reports in Gastroenterology ◽

10.1159/000508426 ◽

2020 ◽

Vol 14 (2) ◽

pp. 448-452

Author(s):

Pratik Khatiwada ◽

Jose A. Rodriguez ◽

Andres Reyes-Corcho

Keyword(s):

Alkaline Phosphatase ◽

Liver Disease ◽

Alcoholic Hepatitis ◽

Hepatitis A ◽

Acute Onset ◽

Common Disease ◽

Common Condition ◽

Hepatic Carcinoma ◽

Elevated Alkaline Phosphatase ◽

Uncommon Presentation

Alcoholic liver disease is one of the leading causes of hepatitis, cirrhosis, liver failure, and hepatic carcinoma. Alcoholic hepatitis refers to the acute onset of symptomatic hepatitis. We describe a patient who presented with alcoholic hepatitis with direct hyperbilirubinemia, elevated alkaline phosphatase (ALP), and hypertriglyceridemia. All the imaging and laboratory work excluded obstructive causes, and liver biopsy confirmed the diagnosis. Alcoholic hepatitis is a common condition, but some unusual presentations can lead one to think of uncommon pathologies. This case reflects that alcoholic hepatitis can present with high levels of triglycerides as well as a cholestatic pattern with direct hyperbilirubinemia and ALP without an obvious obstruction cause.

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Tuberculous Dactylitis: An Uncommon Presentation of a Common Infection

Case Reports in Pediatrics ◽

10.1155/2016/4013471 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

G. Nayantara Rao ◽

Jayasri Helen Gali ◽

S. Narasimha Rao

Keyword(s):

Rare Entity ◽

Osteoarticular Tuberculosis ◽

Unusual Form ◽

Uncommon Presentation ◽

Contralateral Hand ◽

Diagnostic Difficulties ◽

Hands And Feet ◽

Common Infection ◽

Tubular Bones

Tuberculous dactylitis is an unusual form of osteoarticular tuberculosis involving the short tubular bones of hands and feet, which is uncommon beyond six years of age. We report the case of a fifteen-year-old adolescent boy who was diagnosed with tuberculous dactylitis, involving contralateral hand and foot. His diagnosis was delayed due to lack of suspicion of this rare entity. The report also examines the diagnostic difficulties faced by clinicians in arriving at an appropriate diagnosis.

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Application of solid-phase immune electron microscopy to study physical and stability characteristics of enterically transmitted non-a, non-b hepatitis virus

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100102481 ◽

1988 ◽

Vol 46 ◽

pp. 80-81

Author(s):

Charles D. Humphrey ◽

E. H. Cook ◽

Karen A. McCaustland ◽

Daniel W. Bradley

Keyword(s):

Electron Microscopy ◽

Hepatitis A ◽

Hepatitis A Virus ◽

Solid Phase ◽

Etiologic Agent ◽

World Health ◽

Health Concern ◽

Morphological Identification ◽

Immune Electron Microscopy

Enterically transmitted non-A, non-B hepatitis (ET-NANBH) is a type of hepatitis which is increasingly becoming a significant world health concern. As with hepatitis A virus (HAV), spread is by the fecal-oral mode of transmission. Until recently, the etiologic agent had not been isolated and identified. We have succeeded in the isolation and preliminary characterization of this virus and demonstrating that this agent can cause hepatic disease and seroconversion in experimental primates. Our characterization of this virus was facilitated by immune (IEM) and solid phase immune electron microscopic (SPIEM) methodologies.Many immune electron microscopy methodologies have been used for morphological identification and characterization of viruses. We have previously reported a highly effective solid phase immune electron microscopy procedure which facilitated identification of hepatitis A virus (HAV) in crude cell culture extracts. More recently we have reported utilization of the method for identification of an etiologic agent responsible for (ET-NANBH).

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Hepatitis A Antigen in Liver, Bile and Stool

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100115328 ◽

1975 ◽

Vol 33 ◽

pp. 340-341

Author(s):

D.R. Jackson ◽

J.H. Hoofnagle ◽

A.N. Schulman ◽

J.L. Dienstag ◽

R.H. Purcell ◽

...

Keyword(s):

Hepatitis A ◽

Liver Enzymes ◽

Hepatitis A Virus ◽

Type A ◽

Initial Study ◽

Virus Like Particle ◽

Elevated Liver Enzymes ◽

Ag Particles ◽

Ag Particle ◽

Human Stool

Using immune electron microscopy Feinstone et. al. demonstrated the presence of a 27 nm virus-like particle in acute-phase stools of patients with viral hepatitis, type A, These hepatitis A antigen (HA Ag) particles were aggregated by convalescent serum from patients with type A hepatitis but not by pre-infection serum. Subsequently Dienstag et. al. and Maynard et. al. produced acute hepatitis in chimpanzees by inoculation with human stool containing HA Ag. During the early acute disease, virus like particles antigenically, morphologically and biophysically identical to the human HA Ag particle were found in chimpanzee stool. Recently Hilleman et. al. have described similar particles in liver and serum of marmosets infected with hepatitis A virus (HAV). We have investigated liver, bile and stool from chimpanzees and marmosets experimentally infected with HAV. In an initial study, a chimpanzee (no.785) inoculated with HA Ag-containing stool developed elevated liver enzymes 21 days after exposure.

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