Response to the outbreak of severe acute hepatitis of unknown origin in children

Severe Acute Hepatitis: An Emerging Grave Illness in Children

“…As the etiology of this condition is still not understood fully, the mainstay of therapy for severe acute hepatitis of unknown etiology in children is supportive. Patient consciousness, volume status, urine volume, blood electrolytes, liver function, and coagulation function should be closely monitored during the entire treatment period, as should maintenance of water, electrolyte and acid-base balance [18]. Approximately 6-10% of children require liver transplantation and liver transplantation is necessary for children with ALF who fail to improve with supportive measures.…”

Viral hepatitis, hallmarks and molecular features

“…Quantification of alpha-fetoprotein (AFP) is commonly used as a biomarker for early detection and follow-up of hepatic cell carcinoma. 8,21,[65][66][67][68]…”

“…It is a disease that can progress to cirrhosis, liver cell carcinoma, liver failure and eventually death. [6][7][8][9][10][11][12] Recently the WHO has published reports of outbreaks of hepatitis of unknown etiology in several European and American countries. At least 169 cases, as of April 21st, 2022, all of them in children under 16 years of age.…”

Hepatitis of Unknown Origin in Children

“…The etiology of hepatitis can be multifactorial and varied, and it is necessary to highlight the infectious, autoimmune, pharmacological, and metabolic-genetic origin, however, the cause of the acute development of these cases is currently still being investigated since it has not been detected in any way. The presence of hepatotropic viruses commonly related to the disease (hepatitis A, B, C, D and E) (3) is routine, so for epidemiological purposes it has been called "non-HepA-E acute hepatitis" [7,8]. According to reports established by the European Centers for Disease Control and Prevention (ECDC) in partnership with the UK Health Security Agency and the US Centers for Disease Control and Prevention (CDC), the origin can be developed from different hypotheses that include cofactors that transform a common infection into the most severe form, the role of a known agent that undergoes critical genetic changes that modify its pathogenicity, the coinfection between two or more viruses, the appearance of a new infectious agent, unexplored immunological alterations and finally, the role of toxic or environmental agents [9].…”