Acute hepatitis B (HBV) infection is asymptomatic, subclinical illness in approximately two thirds of cases and diagnosis is made only through serologic testing7. Clinical evidence of hepatitis; jaundice and occasionally acute liver failure develops in rest one third of patients with acute HBV infection7. Cholestatic hepatitis is one of very rare manifestations of acute HBV infection, but when develop it leads to prolonged hospital stay and increased medical expenses5. Rapid improvement of the clinical symptoms and signs have been reported in patients with cholestatic hepatitis A (HAV) after use of corticosteroid6. We here report a case of cholestatic hepatitis due to acute HBV infection and rapid improvement of symptoms with oral prednisolone.
A 56-year old female patient presented with complaints of progressively increasing jaundice and intense pruritus that disturbed sleep for 12 weeks duration. She had been evaluated at a local hospital and diagnosed to have acute viral hepatitis due to hepatitis B virus infection (HBV) on the basis of raised liver enzymes and serological markers (Table 1).
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