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Jaundice in primary school pupils

¹ Department of Infectious Diseases and Tropical Medicine, Leicester Royal Infirmary, Leicester LE1 5WW, UK
² Department of Communicable Disease Control and Public Health Medicine, Leicestershire Health, Leicester, UK

Correspondence to:
Correspondence to:
Dr Stephenson;
istephen@globalnet.co.uk

Submitted 8 December 2000
Accepted 25 January 2001

Keywords: jaundice; hepatitis A

A previously well 10 year old boy was admitted from school with increasing epigastric pain and vomiting. He had a six day history of feeling generally unwell and feverish with loose motions. On examination he was well, pyrexial at 37.6°C and mildly icteric with epigastric tenderness. There was no organomegaly. Investigations included normal full blood count, differential white count, urea, electrolytes, and chest radiography. Liver function was mildly deranged with alanine aminotransferase (ALT) 250 U/l, alkaline phosphatase (ALP) 280 U/l, and bilirubin 67µmol/l. Paul-Bunnell test and hepatitis B surface antigen were negative. A diagnostic test was performed. He improved after 48 hours and was discharged home well.

Ten days later, a teacher from the same school presented to her general practitioner with nausea, vomiting, abdominal pain, and jaundice. On examination she was deeply icteric with no stigmata of chronic liver disease. Investigations revealed a normal full blood count with . . . [Full text of this article]