Severe acute hepatitis in children: investigate SARS-CoV-2 superantigens

Brodin, Petter; Arditi, Moshe

doi:10.1016/s2468-1253(22)00166-2

Cited by 119 publications

(144 citation statements)

References 6 publications

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“…SARS-CoV-2 superantigen was supposed to be a causal mechanism of multisystem inflammatory syndrome in children [ 14 , 15 ]. Both SARS-CoV-2 and adenovirus were detected in a few patients [ 7 ], and in these patients, adenovirus infection in the intestine might induce a SARS-CoV-2 superantigen reaction and cause immunopathological hepatitis [ 16 ].…”

Section: Hypothesized Etiologiesmentioning

confidence: 99%

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children

et al. 2022

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Background Severe acute hepatitis of unknown etiology in children has recently exhibited a global trend of concentrated occurrence. This review aimed to summarize the current available information regarding the outbreak of severe acute hepatitis and introduce our hospital’s previous experiences with the diagnosis and treatment of severe acute hepatitis for reference. Data sources Websites including the UK Health Security Agency, European Centre for Disease Prevention and Control, CDC, WHO, and databases including PubMed/Medline, Cochrane Library, Embase and Web of Science were searched for articles on severe acute hepatitis in children. Results As of May 26, 2022, a total of 650 cases have been reported in 33 countries; at least 38 (6%) children required liver transplantation, and nine (1%) died. Cases are predominantly aged between 3 and 5 years old, and there are no epidemiological links among them. The common manifestations are jaundice, vomiting and pale stools. Adenovirus tested positive in most cases, and SARS-CoV-2 and other viruses were detected in a few cases, but virus particles were not found in liver tissue. Adenovirus immunohistochemistry showed immunoreactivity in the intrasinusoidal lumen from some liver samples. The hierarchical treatment includes symptomatic and supportive therapy, management of coagulation disorders and hepatic encephalopathy, artificial liver support, and liver transplantation (approximately 6%–10% of cases require liver transplant). Conclusions The etiology of this severe acute hepatitis in children is not clear. The clinical features are severe acute hepatitis with significantly elevated liver enzymes. Clinicians need to be alert to children with hepatitis.

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Section: Hypothesized Etiologiesmentioning

confidence: 99%

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children

et al. 2022

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“…So it has been speculated that acute severe hepatitis in children could be a consequence of adenovirus infection with intestinal trophism in children previously infected by SARS-CoV-2 and carrying viral reservoirs. Based on this hypothesis, it is suggested that children with acute hepatitis should be investigated for SARS-CoV-2 persistence in stool, T-cell receptor skewing and IFN-γ upregulation [ 22 ].…”

Section: Sars-cov-2: Superpower To Trigger the Immune Casca...mentioning

confidence: 99%

Acute severe hepatitis of unknown origin in children: considerations from the perspective of immunology

2022

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“…So what is the cause of these children's sudden hepatitis? Based on the current global case investigation and comprehensive information from the European Centers for Disease Control and Prevention (ECDC), the UK National Health Security Agency, and the USA Centers for Disease Control and Prevention (CDC), potential causes are speculated including adenovirus (HAdV) infection (normal adenovirus or new variant adenovirus), SARS-CoV-2 virus post-infection syndrome or SARS-CoV-2 new variant strain infection, drug, toxin or environmental exposures, unknown pathogens alone or coinfection [1,[8][9][10][11][12][13].…”

Section: Underlying Causesmentioning

confidence: 99%

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

2022

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Severe acute hepatitis in children: investigate SARS-CoV-2 superantigens

Cited by 119 publications

References 6 publications

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children

Acute severe hepatitis of unknown origin in children: considerations from the perspective of immunology

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

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