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J Korean Soc Emerg Med > Volume 13(3); 2002 > Article
Journal of The Korean Society of Emergency Medicine 2002;13(3): 306-311.
Clinical Review of Acute Hepatitis A in a Emergency Center
Young Ho Kwak, Jung Ho Shin, Sung Koo Jung, Joong Eui Rhee, Gil Joon Suh, Chang Hyun Lee, Yeo Kyu Youn
1Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea. suhgil@snu.ac.kr
2Department of Surgery, Cheju National University College of Medicine, Cheju, Korea.
We conducted this study to evaluate the clinical manifestations of acute hepatitis A in an emergency center.
All hepatitis A patients who visited the emergency center of Seoul National University Hospital from October 1999 to March 2002 were analyzed using a retrospective medical record review. Variables included in the data analysis were age, sex, clinical symptoms and signs, and laboratory findings on initial presentation and their peak values.
A total of 31 patients showed positive for the anti-HAV IgM antibody, and 29 patients had apparent hepatitis A. The number of hepatitis A cases per month in 1999, 2000, 2001, and 2002 were 1.33, 0.25, 0.92, and 4.3, respectively. Among the 29 patients, 15 were brought to the emergency center and constituted the study group. The mean age were 22.3 years old. The most common symptoms were nausea and vomiting (100%), followed by fever (86.7%), anorexia (66.7%). Common signs were jaundice (53.3%) and hepatomegaly (46.7%). Seven patients admitted via the outpatient department were older and had a longer duration of symptoms from onset to diagnosis than the study group. The mean values of the initial laboratory tests were serum aspartate aminotransferase (AST) of 3,044 IU/L, alanine aminotransferase (ALT) of 3,521 IU/L, and a total bilirubin of 4.15 mg/dL. The peak mean values of those variables were 4,067 IU/L, 4,662 IU/L and 7.35 mg/dL, respectively. All patients recoverd without complications.
Patients with hepatitis A showed benign clinical features. This study revealed a trend of increasing incidence of hepatitis A in adults and suggested the possibility of an outbreak. Further effort to prevent the propagation of the disease is warranted.
Key words: Hepatitis A, Emergency center
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