A 5-year-old child that contacts with viral hepatitis in the kindergarten presents with increased body temperature up to 38°C, weakness, low appetite, single case of vomiting, dull pain in the subcostal area on the right. The child is provisionally diagnosed with viral hepatitis. What examination would be the most informative for diagnosis confirmation?

Answer options

1. Thymol turbidity test
2. Feces analysis for stercobilin
3. Blood test for bilirubin
4. Urine analysis for bile pigments
5. ALT activity in blood

Explanation

To confirm the presence of acute hepatitis, which was suspected according to epidemiological (contact with viral hepatitis in the kindergarten) and clinical (increased body temperature up to 38 ºC, weakness, low appetite, sole case of vomiting, dull pain in the subcostal area on the right) data, in prehistoric period transaminase (ALT) level, which reflects cytolytic syndrome, should be checked. The transaminase levels in acute hepatitis may reach 5–100 times normal. Infection with HAV can be diagnosed by the presence of anti-HAV IgM with very high sensitivity and specificity 1. Harrison’s Principles of Internal Medicine / D. L. Kasper et al. – 19th Ed. – McGraw-Hill, 2015. – P. 2004– 2023. 2. Infectious Diseases / J. Cohen et al. – 3rd Ed. – Mosby, 2010 [pdf 182 MB]. – P. 408–413