Patient's question:
My daughter is now one year old. She was diagnosed with infant hepatitis syndrome in a multi-specialty hospital, where her ALT and bilirubin levels were very high. She was treated in the best hospital in Chengdu for one month, but when she was discharged, nothing had improved, and her levels had even increased slightly. Later, after taking traditional Chinese medicine for over 10 months, we had another check-up. Her ALT levels did not decrease, but her total bilirubin levels dropped by over 100. Now, the child is over one year old and still not showing signs of improvement. The excessive medication has not allowed her to develop properly. We have sent her to various hospitals, and all the children who stayed in the hospital with her have left. I really don’t know how to treat her for her to truly get better! Additionally, the child has not received any vaccinations since she was so young, and I’m unsure whether she can now.Doctor's answer:
Infantile Hepatitis SyndromeIt refers to a group of symptoms caused by different etiologies in infants under one year of age (including newborns), primarily characterized by jaundice, liver function damage, and hepatosplenomegaly. Recent studies suggest that this condition is due to an enhanced and prolonged physiological biliary obstruction during the perinatal period caused by certain pathogens, and liver biopsy may show multinuclear giant cell transformation and inflammatory changes. The causes of this syndrome include: 1) Infections: such as viral infections like cytomegalovirus (CMV), hepatitis virus, Epstein-Barr virus, rubella virus, enterovirus, herpes virus, adenovirus, and yellow fever virus, as well as various bacterial infections and toxoplasmosis. 2) Congenital metabolic disorders: such as Wilson's disease, galactosemia, fructose intolerance, and α1-antitrypsin deficiency. 3) Intrahepatic or extrahepatic biliary abnormalities: such as congenital biliary atresia. Currently, the main pathogens causing infantile hepatitis syndrome are hepatitis B virus and cytomegalovirus. In some regional reports, bacterial infections also account for a significant proportion. The detection rate of cytomegalovirus infection is relatively high among hospitalized mothers and newborns at the Second Hospital of Nanjing Liver Diseases and Obstetrics and Gynecology. The onset of this syndrome is often insidious. If it presents acutely and is accompanied by a secondary infectious disease, without serological evidence, it may be misdiagnosed as infectious toxic hepatitis. Additionally, cytomegalovirus hepatitis is associated with biliary malformations. Due to the complex etiology of infantile syndrome, diagnosis and treatment can be challenging. Some have proposed that when jaundice is observed in infants and young children under the following conditions, viral hepatitis should be considered less likely: 1) Jaundice in newborns and infants; 2) Prolonged fever with high temperature, high or low blood count; 3) Persistent jaundice that does not subside over time; 4) Accompanied by significant anemia; 5) Accompanied by signs of multisystem involvement.