Severe acute hepatitis of unknown causes in children – Current findings, questions, opinions, and recommendations, a mini‐review

Abstract

Since October 2021 in Alabama, the United States, and March 2022 in central Scotland, the United Kingdom, the number of cases of severe acute hepatitis of unknown etiology/causes in children was found to increase, and the total number of cases has reached 920 worldwide by June 22 this year, 45 cases (5%) required liver transplantation, and 18 cases (2%) died according to World Health Organization (WHO). To understand the basic characteristics of this disease/syndrome, a literature search was performed at PubMed, websites of WHO, UK Health Security Agency, and US and European Centers for Disease Control and Prevention, and more than 20 reports were enrolled as references for this review. The main clinical manifestations are anorexia, vomiting, fatigue, jaundice, and so forth. Most of the cases seemed to have a self-limited course of the disease, about 6% of cases may develop life-threatening acute liver failure. The disease seems to be transmissible from person to person. Human adenovirus was detected in up to 75% of cases, but this virus seems not to be the only and major etiologic agent, other cofactors probably are involved. Researchers proposed many hypotheses concerning the etiology and pathogenesis, and many important works and studies are ongoing. This mini-review is aimed at summarizing, reviewing, and further understanding the characteristics of the disease, raising some clinically relevant questions, and trying to discuss some questions that may be related to the treatment of the disease for consideration. KEYWORDSAcute liver failure, Children, Severe acute hepatitis of unknown causes How to cite this article: Zhaori G. Severe acute hepatitis of unknown causes in children -Current findings, questions, opinions, and recommendations, a mini-review.

Early Detection Training Program for Acute Hepatitis in Children for the Community of Malasom Village, Sorong Regency, Southwest Papua Province.

“…Acute hepatitis is something condition that occurs when the heart experience inflammation caused by a viral infection. Otherwise detected and treated with the fast condition, this can cause damage permanent to the heart, even death, because that is important for parents to get training in detecting early acute hepatitis in children them (Zhaori, 2022).…”

Infección por adenovirus humano como potencial causante de hepatitis en pediatría

“…Es necesario realizar las pruebas de daño hepático (AST, ALT, fosfatasa alcalina, GGT), así como las pruebas de función hepática (bilirrubina total y conjugada, albúmina, INR). Parte de las pruebas deben incluir la valoración de hepatitis virales agudas (serología para hepatitis A, B, C, D, y E), además de otros virus como EBV, CMV y VIH (Zhaori, 2022). También de acuerdo con el contexto epidemiológico de hoy en día, se deben tener en consideración los virus respiratorios (adenovirus, influenza A y B, SARS-CoV-2) y patógenos específicos del sistema gastrointestinal (identificación de adenovirus y rotavirus en heces, coprocultivo).…”

“…También de acuerdo con el contexto epidemiológico de hoy en día, se deben tener en consideración los virus respiratorios (adenovirus, influenza A y B, SARS-CoV-2) y patógenos específicos del sistema gastrointestinal (identificación de adenovirus y rotavirus en heces, coprocultivo). El gold standard para determinar los cambios patológicos y patógenos en el tejido hepático es la biopsia además brinda información del proceso disruptivo en el hígado (Uwishema et al, 2022;Zhaori, 2022;Gao et al, 2022).…”

The Outbreak of Unexplained Acute Hepatitis in Children: The Role of Viral Infections in View of the COVID-19 Pandemic

“…An initial report from the United Kingdom in early April 2022 of an increased number of children with acute hepatitis of unknown origin (HUO) gained attention worldwide and led to reports of more than 1000 children with HUO two months later. An interim review of the published cases up to June 2022 [1] showed that 45 cases (5%) of the 920 probable cases required liver transplantation and 18 cases (2%) died. An international online survey affirmed the impression that there was indeed an increase in acute hepatitis in 2022 compared to the previous 5 years.…”