Acute hepatitis and adenovirus infection among children—Alabama, October 2021–February 2022

Baker, Julia M; Buchfellner, Markus; Britt, William J.; Sánchez, Verónica; Potter, Jennifer L; Ingram, L. Amanda; Shiau, Henry; Sanchez, Luz Helena Gutierrez; Saaybi, Stephanie; Kelly, David R.; Lu, Xiaoyan; Vega, Everardo; Ayers-Millsap, Stephanie; Willeford, Wesley G; Rassaei, Negar; Bullock, Hannah; Reagan‐Steiner, Sarah; Martin, Ali; Moulton, Elizabeth A; Lamson, Daryl M.; George, Kirsten St.; Parashar, Umesh D.; Hall, Aron J.; MacNeil, Adam; Tate, Jacqueline E.; Kirking, Hannah L.

doi:10.1111/ajt.16665

Cited by 16 publications

(25 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,7 As in the majority of cases in the UK, 4,5 an adenovirus was also detected in our first case (in the respiratory panel and stools), although the revealed serotype in our case was not the one being currently considered as the most likely culprit by the international scientific community (the 41F serotype, not previously known to cause severe AH). 4,9 Besides, in the UK, this adenovirus is being more easily detected in the blood or serum than in stool or respiratory samples, 4 contrary to what happened in our case, where no adenoviral DNA could be detected in blood PCR.…”

Section: Discussioncontrasting

confidence: 57%

“…5 There are reports of positive EBV by PCR testing with negative EBV IgM antibodies in the context of some these unexplained hepatitis cases, and even other agents such as CMV have also been identified in some cases, although in lower frequency. [5][6][7]9 Another possible theory is that all these newly identified AH cases can be due to acute COVID-19 (with perhaps a new variant and incidental isolation of other viruses) or that we could be looking at yet another form of a post infectious SARS-CoV-2 syndrome. 4,6,7,9 Weeks after the SARS-CoV-2 delta variant outbreak, there were reports in India of 37 children with mild hepatitis with preserved synthetic liver function and no jaundice.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7]9 Another possible theory is that all these newly identified AH cases can be due to acute COVID-19 (with perhaps a new variant and incidental isolation of other viruses) or that we could be looking at yet another form of a post infectious SARS-CoV-2 syndrome. 4,6,7,9 Weeks after the SARS-CoV-2 delta variant outbreak, there were reports in India of 37 children with mild hepatitis with preserved synthetic liver function and no jaundice. 7,10 Although these seem to be less severe than the newly reported AH cases, it cannot be ruled out that they can still represent a more severe end of spectrum of the same condition.…”

Section: Discussionmentioning

confidence: 99%

“…7 However, this seems to be unlikely, since most children with AH in the UK and other countries have, so far, tested negative for SARS-CoV-2 acute infection on admission. 4,6,7,9 Nevertheless, it is logical that most of these children had had a previous COVID-19 infection and serological testing has been supportive of this fact. 9 Another prominent hypothesis to consider is the possibility of a shared role between SARS-CoV-2 and other viruses (such as adenovirus), in the pathophysiology of these unexplained hepatitis cases.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Acute Hepatitis of Unknown Origin in Children: Two Cases in a Portuguese Hospital

et al. 2023

View full text Add to dashboard Cite

Several cases of paediatric acute hepatitis of an unknown aetiology have been described in these last few months and in several countries worldwide. We present two patients, a 7-month-old girl and an 8-year-old boy, with gastrointestinal symptoms and lethargy, associated with elevation of transaminase levels. Serologies for hepatitis A-E virus and PCR test to SARS-CoV-2 were all negative. In the first case, an adenovirus serotype C could be isolated in a respiratory sample as well as cytomegalovirus (CMV) in the blood (100 copies/mL). In both children, there was a progressive decrease in the hepatic markers and symptomatic resolution, compatible with a good prognosis, also seen globally in most cases. To date, infection remains the most plausible cause to consider, especially when it is presumed to be linked to adenovirus. Other potential agents and causes are still being evaluated, thus emphasizing the importance of continuous epidemiological surveillance, notification, and detailed study of all hepatitis cases.

show abstract

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Hepatitis of Unknown Origin in Children: Two Cases in a Portuguese Hospital

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In the era of increasing deceased donors, racial and ethnic diversity and borderless spread of communicable diseases worldwide, attention should be paid to DDIs. The increased presence of antimicrobial-resistant organisms in the general population, 39 the SARS-CoV-2 pandemic, 40 and a recent surge in acute liver failure cases in some countries 41 remind us of the need for comprehensive monitoring systems to be established for all transplantation cases.…”

Section: Donor-derived Infection Transmissionmentioning

confidence: 99%

Pediatric Infectious Diseases Related to Transplantation: Insights From Japan

Yamada

Shoji

Miyairi³

et al. 2022

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Infectious diseases after transplantation account for significant morbidity and mortality in children undergoing transplantation; the importance of pediatric transplant infectious disease (TID) specialists has therefore been recognized. Although tremendous advancement continues in transplantation medicine, pediatric-specific data and evidence are limited. In Japan, the majority of TIDs had not been managed by infectious disease specialists because pediatric infectious diseases have not been recognized as a solo subspecialty until recently in Japan. However, in the last decade, there was a new movement for pediatric TID in Japan; some pediatric infectious disease specialists trained outside Japan have been playing an important role in managing pediatric TID in a few academic and pediatric institutions. In this review article, we introduce the current status of infectious complications related to pediatric hematopoietic cell and solid organ transplantation, highlighting currently available local evidence, common practice and issues in the field of pediatric TID in Japan.

show abstract

Characterization of a Hepatitis Outbreak in Children, 2021 to 2022

Alexander

Deep

2022

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceAfter a cluster of pediatric cases of hepatitis of unknown etiology were identified in Scotland in March 2022, the World Health Organization published an outbreak alert, and more than 1010 probable cases were reported. Some cases progressed to acute liver failure and required liver transplant. Although many patients had positive results for adenovirus on polymerase chain reaction testing from whole blood samples and/or reported recent COVID-19 infection (with or without seropositivity), the precise pathogenesis remains unclear despite the high potential morbidity of this condition.ObjectiveTo summarize the currently available evidence regarding novel pediatric hepatitis of unknown etiology (or novel hepatitis), encompassing case numbers, testing, management, and outcomes.Evidence ReviewA rapid review of the literature from April 1, 2021, to August 30, 2022, aimed to identify all available published case series and case-control studies of novel hepatitis. The search included PubMed and references and citations of short-listed studies.FindingsA total of 22 available case series and case-control studies describing 1643 cases were identified, with 120 children (7.3%) receiving liver transplants and 24 deaths (1.5%). Outcome reporting and testing for adenovirus and SARS-CoV-2 was incomplete. Assessment of disease severity and management was mixed and results regarding testing for adenovirus and SARS-CoV-2 were inconsistent for both serological testing and testing of explant or biopsy liver samples. More recent studies suggest a more plausible role for adenovirus and/or adeno-associated virus 2.Conclusions and RelevanceThis systematic review without meta-analysis describes the challenge posed by hepatitis of unknown etiology in terms of investigation and management, with many cases progressing to acute liver failure. The lack of clarity regarding pathogenesis means that these children may be missing the potential for targeted therapies to improve outcomes and avert the need for transplant. Clinicians, immunologists, and epidemiologists must collaborate to investigate the pathogenesis of this novel hepatitis.

show abstract

Acute hepatitis and adenovirus infection among children—Alabama, October 2021–February 2022

Cited by 16 publications

References 8 publications

Acute Hepatitis of Unknown Origin in Children: Two Cases in a Portuguese Hospital

Acute Hepatitis of Unknown Origin in Children: Two Cases in a Portuguese Hospital

Pediatric Infectious Diseases Related to Transplantation: Insights From Japan

Characterization of a Hepatitis Outbreak in Children, 2021 to 2022

Contact Info

Product

Resources

About