Successful Management of Acute Viral Hepatitis A complicated by Hypokalemia, Thrombocytopenia, Respiratory Alkalosis and Ascites: A Case Report

Introduction: Acute viral hepatitis A is a self-limiting liver infection caused by the hepatitis A virus (HAV). Although most pediatric cases are benign, some children may develop severe complications, including hypokalaemia, thrombocytopenia, respiratory alkalosis, and ascites. Prompt recognition and management of these complications are essential to improving outcomes. This case report discusses a 15-month-old child with acute viral hepatitis A who presented with these complications, highlighting the importance of early intervention.Case Report: A 15-month-old boy was admitted to the Pediatric Intensive Care Unit (PICU) with a 3-day history of jaundice, vomiting, and bradycardia. Laboratory tests revealed severe hypokalaemia (K⁺ = 2.84 mmol/L), deranged liver function tests, and thrombocytopenia. The patient was treated with intravenous fluids, potassium correction, broad-spectrum antibiotics, and supportive care. Imaging confirmed mild ascites, gallbladder wall edema, and splenomegaly. HAV infection was confirmed serologically (IgM positive). Over the next 48 hours, his condition improved, with the resolution of bradycardia, stabilization of electrolytes, and normalization of liver function. He was discharged after 8 days in stable condition, with follow-up planned for nutritional support and further liver monitoring. Conclusion: This case illustrates the potential for complications such as hypokalaemia, thrombocytopenia, respiratory alkalosis, and ascites in pediatric patients with hepatitis A. Early identification and comprehensive supportive care can lead to favourable outcomes. Similar cases emphasize the need for careful monitoring and prompt intervention to prevent severe consequences in children with acute viral hepatitis A.