Purpose Several outbreaks of acute hepatitis of unknown etiology (AHUE) in children were reported in 2022 in many countries, with adenovirus identified as the etiological agent in most of them. We aimed to evaluate the characteristics and outcomes of AHUE cases in Egypt. Methodology Hospitalized patients with acute hepatitis were included in the study. Drug-induced, alcoholic hepatitis, autoimmune hepatitis, and Wilson’s disease were identified either by medical history or by routine laboratory diagnosis. Molecular and serological approaches were used to investigate common viral causes of hepatitis, such as hepatitis A–E viruses, cytomegalovirus, Epstein–Barr virus, herpes simplex viruses (HSV1/2), adenovirus, parvovirus B19, and coxsackie virus. Results A total of 42 patients were recruited and divided into two groups: 24 cases of unknown hepatitis after excluding the common causes and 18 cases of known hepatitis. About two-thirds of the patients were male (61.9%), and the mean age was 34.55 ± 16.27 years. Jaundice, dark urine, abdominal pain and diarrhea were recorded at a higher incidence in group 1, while jaundice and fever were frequent in group 2. Fulminant hepatitis occurred in 28.6% of the cases, but the two groups did not differ significantly in terms of patient outcome, duration of hospitalization, ascites, and development of fulminant hepatitis. Adenovirus was detected in five cases (20.8%) in group 1, and one case co-infecting with hepatitis E virus in group 2. Herpes simplex virus 1/2, coxsackie virus, and parvovirus B19 were not detected in any case, while etiologies of 75% of the cases were still not confirmed. One out of the six adenovirus-infected patients died. The outcome significantly correlated with the severity of the liver disease. Conclusion This is the first report describing etiologies and characteristics of AHUE cases in Egypt, and interestingly, adenovirus was detected in adults. Further studies are required to determine the prevalence of this newly emerging viral hepatitis pathogens.

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This study aimed to report the dynamic profile of IgG-specific antibodies to SARS-CoV-2 infection for 6 months after infection. We conducted a prospective study, recruited 33 recently confirmed covid -19 patients and collected 6 samples from each patient. The first samples were collected one month from the start of symptoms and subsequent samples collected at 30 days interval. We measured the IgG by chemiluminescent immunoassay (CLIA). According to the disease severity, patients were categorized as asymptomatic 4 (12.1%), mild 14 (42,4%), moderate 9 (27.3%), and severe 6 (18.2%). Patients were 12 (35.3%) females and 21 (64.7%) males. The mean IgG levels maintained a high level till the second month (92.81 ± 110.15 AU/ml) from the onset of symptoms followed by a gradual decrease till the sixth month after infection (17.42 ± 22.61 AU/ml). The patients with severe symptoms significantly exhibited the highest IgG levels, reached the highest level (mean=237.44 ± 164.13 AU/ml) at the second month. While the lowest levels were detected among the asymptomatic patients (mean= 3.04 ± 2.94 AU/ml) at the second month. Older age correlated with higher IgG antibody level (r= 0.350 p=0.046); however, sex was not related to IgG level. In conclusion, Symptomatic COVID-19 disease is followed by protective immunity for more than 6 months. Immunity in asymptomatic patients is low and fades rapidly than symptomatic cases. Patients with severe disease had significantly higher IgG levels compared to mild, moderate, or asymptomatic patients.

Background Chronic hepatitis C (HCV) and B viruses (HBV) represent the commonest global causes of liver cirrhosis. Other etiologies of non-viral cirrhosis such as autoimmune, metabolic, vascular, or biliary diseases are underestimated. The study aimed to identify causes, clinicoepidemiological characteristics, and outcome of non-B non-C liver cirrhosis. This Egyptian multicenter study recruited patients with liver cirrhosis excluding HCV and HBV. Clinical evaluation and the mortality were recorded. Laboratory, radiological, and histopathological assessment to diagnose the etiology was performed. Results One hundred eighty-eight patients were included: 54.3% were males. Autoimmune hepatitis (AIH) was the most common cause of cirrhosis (28.2%), followed by Budd-Chiari syndrome (BCS) in 25%, and cryptogenic in 23.9%. Metabolic causes such as Wilson’s disease, non-alcoholic steatohepatitis (NASH), and hemochromatosis were reported in 7.4%, 3.2%, and 1.1%, respectively. Biliary and cardiac cirrhosis were less frequent. Older age was prevalent in hemochromatosis (67.5 ± 17.7 years) and NASH (60.7 ± 11), while young age in Wilson’s disease (29.5 ± 14.8) and secondary biliary cirrhosis (14.8 ± 4.8). Rural residence was common (60.6%). Mortality was reported in BCS (40.4%), cryptogenic (28.9%), cardiac (25%), Wilson’s disease (21.4%), AIH (17%), and NASH (16.7%). Hepatocellular carcinoma complicated 10.6% of cases. A significantly high percentage of patients had decompensated cirrhosis. Child–Pugh class and rural residence were significant predictors of mortality. Conclusion This first report on non-B non-C cirrhosis in Egypt revealed a high prevalence of AIH, BCS, and cryptogenic cirrhosis. Advanced Child class and rural residence were the predictors of mortality.

Introduction: Irritable bowel syndrome is a worldwide functional gastrointestinal illness, but its main cause is not definite. The primary cause of gastritis, peptic ulcers, and stomach cancer is Helicobacter pylori. The exact relation between H. pylori infection and IBS incidence is still indefinite. Aim of the work: To assess any potential link between Helicobacter pylori infection and the incidence of irritable bowel syndrome. Patients and method: In our study, we recruited 95 patients. They were divided into Group (1) including those who fulfilled the IBS diagnosis (in compliance with Rome IV criteria) named as a case group and a healthy control group with no IBS diagnosis as Group (2). Every patient enrolled in the study completed a Questionnaire, complete physical examination, H. pylori stool antigen, and stool examination. Results: IBS patients were significantly (P value= 0.001) younger than the control group (32.35± 13.003 vs 41.60± 12.535). Most IBS patients were females (60%) but with no significant difference over males. H. pylori-positive patients were significantly (P value= 0.001) older than the control group (40.47± 12.572 vs 30 ± 13.149). However, there was no discernible gender or stress difference between the two groups. Age (P=0.000) and stress (P=0.000) were discovered through multivariate analysis to be independent predictors of IBS, although H. Pylori infection was not. In conclusion, there was no connection between H. pylori infection and IBS.