Abstract
Hepatitis A virus (HAV) infection in children is typically an acute, self-limited illness associated with general, nonspecific symptoms. Prolonged cholestasis is a rare atypical form of HAV infection that is characterized by serum bilirubin levels higher than 10 mg/dl for more than 12 weeks. Aplastic anemia is another very rare complication of HAV. We report the case of an 11-year-old male with blood group O Rh positive who developed cholestasis followed by aplastic anemia postfulminant HAV infection. Liver function tests rapidly responded to a short course of steroid treatment. The patient had a sickle cell trait and a variant of ABCB11 gene. There was no history of traditional herbal treatment, but we noticed several cautery marks. Immunosuppressive medication was started for aplastic anemia, and he is listed for urgent bone marrow transplant. This is the first reported case of prolonged cholestasis followed by aplastic anemia complicating fulminant HAV infection in a Libyan adolescent.
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