| Virus hepatitis is a generalized disease; people of different constitution may have symptoms of different degrees from various systems. In pediatric virus hepatitis, all of the patient’s organs are directly or indirectly affected by hepatitis virus in the infantile stage or during childhood. In the course of disease immunocomplex (antigen-antibody complex) is formed and deposited in lymph nodes, spleen, vascular endothelium, renal glomerular basement membrane, synovial membrane and choroids plexus tissues where they produce inflammatory and degenerative changes.
According to the course of disease, liver function, immune status and pathologic changes, chronic hepatitis can be divided into “chronic persisting hepatitis” (CPH) and “chronic active hepatitis” (CAH). The former is due to the child’s weak immunologic function and inability to eliminate the hepatitis virus so that the disease is prolonged and cannot be cured; the latter is due to the child’s immunologic defect and insufficient antibodies and inability to eliminate the virus and to inhibit its replication. Furthermore, there are some liver cells, under the action of hypersensitized lymphatic cells being continuously destroyed, so that the disease persists, causing damage of multiple systems and appearance of different clinical symptoms.
Besides chronic hepatitis or acute anicteric hepatitis, subclinically infected patients and patients with occult infection can be all manifest mild, insignificant symptoms or even, may be asymptomatic. But if we can establish the diagnosis of virus hepatitis early enough, the pediatric patient would certainly be treated in time.
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Classification of pediatric chronic hepatitis The clinical symptoms of pediatric hepatitis are summarized into the following forms for the purpose of better understanding and handling of these symptoms. Typical cases are introduced after each form, serving as references in clinical practice.
The 1st form – Lung dryness form The 2nd form – Gastrointestinal, dermal or lower jiao wetness-heat form The 3rd form – Nutritional disturbance or anemic form The 4th form – Endocrine disorder form The 5th form – Hypersensitive constitution form
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By WONG Kwok Hung translated by Professor ZHENG Hua En in July 2005 |