ACUTE LIVER FAILURE WITH PROLONGED CHOLESTASIS FOLLOWING HEPATITIS AINFECTION IN A CHILD: A RARE CASE REPORT

Abstract

We report the case of a 7-year-old female who presented with acute liver failure secondary to hepatitis A virus infection. The acute phase was characterized by high-grade fever, vomiting, icterus, hepatosplenomegaly, hyperbilirubinemia, hyperammonemia, and coagulopathy. She was managed in the paediatric intensive care unit with intravenous N-acetylcysteine, lactulose, vitamin supplementation, ursodeoxycholic acid, and supportive measures, leading to biochemical improvement and symptom resolution. Uniquely, despite marked clinical recovery, she developed prolonged cholestasis during follow-up, with persistent conjugated hyperbilirubinemia ,with direct bilirubin of 10.79 even 8 weeks post-discharge. This case underscores that, although hepatitis A–induced ALF usually resolves completely, rare presentations with prolonged  cholestasis may occur, necessitating prolonged monitoring and targeted management.