Duke Medicine: Hepatitis in children

Hepatitis may be sudden onset (acute) or chronic (long standing). There is a wide range of clinical finding with hepatitis depending on the severity of the inflammation.

Hepatitis may be mild and self-limiting and resolve with no treatment, or it may become chronic and lead to liver failure requiring liver transplant.

The symptoms of hepatitis are similar regardless of the cause of inflammation.

Initially your child may have non-specific flu-like symptoms including fever, fatigue, muscle aches, vomiting, diarrhea and rash. Abdominal pain, yellowing of the skin and eyes (jaundice), and dark urine may occur. A doctor may notice enlargement of the liver on exam.

As hepatitis becomes chronic, the liver may actually become smaller as inflammation is replaced by scarring (fibrosis) of the liver. Extensive scarring of the liver can lead to cirrhosis.

The liver may be unable to produce the proteins needed for normal body functions. This can lead to swelling of the abdomen with fluid (ascites), fluid accumulation of the legs, enlargement of the spleen, or easy bleeding and bruising.

Varices may develop. These are enlarged veins in the esophagus, stomach, intestine, and other organs that may produce life-threatening bleeding. Severe hepatitis may lead to problems with other organ systems such as lung, kidney, and central nervous system as well.