CHOLESTATIC VIRAL-HEPATITIS-A IN ADULTS - CLINICAL, BIOLOGICAL AND HISTOPATHOLOGICAL STUDY OF 9 CASES

Objectives. - We report here 9 cases of acute viral hepatitis A leadin g to hospitalization between June 1989 and October 1992. The main feat ure was a marked and protracted cholestasis. Results. - Jaundice laste d an average of 77 +/- 39 days (range: 30-120) and fetal serum bilirub in concentrations were 265 +/- 184 mu mol/L (range: 51-560). IgM anti- HAV was present in the serum for 6,3 +/- 5,5 months (median: 4, range: 2-19). Histopathological examination of the liver was performed in 6 patients and most showed intralobular cholestasis and portal tract inf lammation associated with dystrophy and paucity of bile ducts. Acute, renal failure was noted in one patient. In three patients, whose pruri tus was not relieved by cholestyramine, plasma exchange was an effecti ve therapy. Conclusion. - These case reports confirm the severity of v iral hepatitis A in adults and emphasize the importance of vaccination .