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Autoimmune hepatitis in a 7 years old boy versus viral hepatitis
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Autoimmune hepatitis in a 7 years old boy versus viral hepatitis

( My apologies, I am not fluent in English, beeing French).
My son, nearly 7 years old, has the following symptoms :
- Mid november to mid december : more and more fatigue.
      no symptom before. No hepatitis before.
- Dec 17th- Dec 24th : vomit about half of his meals and anorexy
                        ( do not want to eat, except jam and
                          some cookies, but in low quantity).
                        Very big fatigue. No interest even in
                        his prefered computer game.
                        No fever.
- Dec 22nd : acute jaundice : skin is yellow, urines very dark,
              feces are very clear.
- Dec 24th : blood test : No A,B, C hepatitis.( he was vaccined
                          against B, 3 years ago).
                          Gamma GT = 91
                          TGO= 2100
              The lever is big : around 4cm ( 1.5inch) appearant
             The gastro-enterologist suspects a AIH or
             Wilson's disease ( he will elimininate the Wilson's
             desisease after some results of this blodd test a
             week later).
- Dec 25th: The boy seems better
- Dec 26th : The boy is extremely well. No fatigue ( plays
             soccer for 30 mn with no reluctance). Always
             hungry:  eat a lot, and do not vomit ( and is
             better and better since that date, that's one week
             Urines & feces become normal ( and stay normal).
             lever seems to become smaller.
- Dec 27th : the gastro enterologists calls us and says that
              the boy has no Wilson's disease, and that he still
              suspect AIH. He says that  the improvement
              maight be temporary, and that he needs a lever
              biopsy. He has not the autoimmune blood test
              results, yet ( he'll have them in 2-3 weeks...).
              He says that he suspects the AIH because the
              lever was firm when he consulted a week before.
- Dec 28th : we see another gastro-enterologist, who gets angry,
              and says that the signs are those of a viral
              infection, specially as the boy is in perfect
              condition now ( happy, smiling, often hungry,
              always willing to play and playing, and the lever
              is about 1-2cm too big (0.5-1 inch)).
              He says that this is probably one of the tens of
              unknown viral hepatitis.
              He orders a blood test.
- Dec 29th : blood test :
               gamma GT=65
               The 2nd gastroenterologist says that we
               "monitor" blood tests twice a month until
               it becomes normal ( max 6 months) and visit
               him only once a month, if the aboves tests
               continue to decrease. But he stays stuck to an
               unknown viral hepatitis. He says that the
               autoimmune tests on the blood taken during
               the acute hepatitis should not be relevant as
               there are autoimmune reactions during an acute
               viral hepatitis.
So , in summary :
-7 years old boy.
-Intense fatigue for one month before the hepatitis symptoms
  ( no symptom before).
-Jaundice, vomit, anorexy, intense fatigue for one week. Lever
is identified 1.5 inch too big during the top of the jaundice.
A first gastroenterologists says that he feels the lever is
-After one week, clinic is OK : no symptom of jaundice. No
  fatigue AT ALL. a second gastroenterologists says that now
  lever is 0.5 inch too big., and is NOT abnormally firm for
  an acute hepatitis.
-No treatment (except antibiotics as he had an angine in the
  same time as the acute jaundice).
- a firts gastroenterologists highly suspects an AIH ( and pushes
   us for a lever biopsy) and a second one highly suspects a Non
   A,B,C  viral hepatitis .

As this is a young boy and that he looks in perfect shape,
  should we only monitor through regular blood test for the
  next 3-6 months and bet for a viral infection or accept the
  lever biopsy right now ?

( BTW, his brother, 9 years old, says since two days that
he feels "badly with the belly", that's to say 1.5 months
after the first symptoms of fatigue of the younger boy, and
1.5 week after the top of the acute jaundice of his brother).

Best regards and thanks a lot.
Jean Francois Galland, an anxious father
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