Human adenovirus observed in children with acute hepatitis of unknown cause: NEJM

UK: Human adenovirus was found in the majority of the 44 young children in recent research by Chayarani Kelgeri and colleagues on acute hepatitis of unknown origin. However, the function in the pathophysiology of this illness has not yet been determined. The findings of this study were published in The New England Journal of Medicine.

There have been more incidences of acute hepatitis in kids with unclear causes reported since January 2022. Despite reports of instances on several continents, the majority have come from the United Kingdom. The causal agent or substances are still being investigated.

Between January 1 and April 11, 2022, a retrospective analysis including kids who were sent to one pediatric liver-transplantation institution in the UK was carried out. In the context of a serum aminotransferase level greater than 500 IU per liter, these kids, who were 10 years old or younger, had hepatitis that met the case definition of the U.K. The Health Security Agency confirmed acute hepatitis that was not hepatitis A through E and did not have a metabolic, congenital, inherited, genetic, or mechanical cause. Clinical features, demographic information, the outcomes of liver biochemical, serologic, and molecular testing for hepatotropic and other viruses, as well as radiologic and clinical outcomes, were evaluated in medical records.

The key findings of this study were:

1. The majority of the 44 kids who had hepatitis and fit the criteria for a confirmed diagnosis were previously healthy.

2. The average age was four years (range, 1 to 7).

3. Jaundice (presented in 93% of the youngsters), vomiting (in 54%), and diarrhea (in 32%) were frequently seen symptoms.

4. 27 (90%) of the 30 patients who had human adenovirus molecular testing were found to be positive. Six patients (14%) experienced fulminant liver failure, and they were all given liver transplants.

5. The patients all survived. All of the kids, including the six who had liver transplants, were allowed to go home.

Source: 

Kelgeri, C., Couper, M., Gupte, G. L., Brant, A., Patel, M., Johansen, L., Valamparampil, J., Ong, E., Hartog, H., Perera, M. T. P. R., Mirza, D., van Mourik, I., Sharif, K., & Hartley, J. (2022). Clinical Spectrum of Children with Acute Hepatitis of Unknown Cause. In New England Journal of Medicine (Vol. 387, Issue 7, pp. 611–619). Massachusetts Medical Society. https://doi.org/10.1056/nejmoa2206704