2 Year Child Having Grossly Elevated Liver Enzymes Without Jaundice. Concerned
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Grossly elevated liver enzymes without icterus ( yellowish discoloration of skin sclera etc ) can be most probably caused by hepatits A virus infection which is a common cause of jaundice in children .
In some children the presentation might be atypical like liver enlargement , fever , elevated liver enzymes without much hyperbilirubinemia etc in contrast to the usual presentation of jaundice .
Sometimes there can be other causes for such anicteric hepatitis like chronic hepatits b infection , other bacterial or viral infections like leptospirosis , dengue etc , metabolic disorders ( mostly inborn ) or drug induced causes of hepatitis .
The next best step would be to consult a pediatrician or pediatric gastroenterologist who can confirm the diagnosis by carrying out blood test like viral markers ( hepatits A , hbsag etc) , coagulation profile and an ultrasound abdomen.The treatment is mostly supportive like that of any acute hepatitis and includes Intravenous fluids , liver protective agents and multivitamin supplements apart from symptomatic treatment .
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