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August 1984

Severe Hepatitis B Virus—Negative Chronic Hepatitis Responsive to Steroids in a Child With Common Variable Hypogammaglobulinemia

Author Affiliations

Department of Pediatrics University of Pavia Piazzale Golgi 1 Policlinico San Matteo Pavia 27100, Italy

Am J Dis Child. 1984;138(8):796. doi:10.1001/archpedi.1984.02140460086033

Sir.—We read with interest the report by Hauser et al1 on 30 children with common variable hypogammaglobulinemia (CVHG). One of them died of chronic active hepatitis (CAH) due to hepatitis B virus (HBV) infection.

Liver disease is uncommon in children with primary hypogammaglobulinemia,2 but CAH related to HBV infection already has been described in young adults.3 We report the case of a young boy with CVHG who manifested an HBV-negative hepatitis and was successfully treated with steroids.

Report of a Case.—A 9-year-old boy had been apparently well until 3 years of age, when the onset of various bacterial infections (pneumonia with pleural effusion, acute otitis media, and pericarditis) together with the finding of panhypogammaglobulinemia and normal peripheral blood B lymphocytes led to the diagnosis of CVHG. He was then treated with intramuscular γ-globulin replacement, periodic cycles of antibiotics, and chest physiotherapy. From the age of