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Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children.
Chen, Ying-Hu; Lou, Jin-Gan; Yang, Zi-Hao; Chen, Qing-Jiang; Hua, Chun-Zhen; Ye, Sheng; Zhang, Chen-Mei; Chen, Jie; Huang, Zong-Wei; Yu, Jin-Dan; Gao, Zhi-Gang; Shu, Qiang.
  • Chen YH; Infectious Disease Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Lou JG; Gastroenterology Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Yang ZH; PICU, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Chen QJ; General Surgery Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310052, China.
  • Hua CZ; Infectious Disease Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Ye S; PICU, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Zhang CM; PICU, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Chen J; Gastroenterology Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Huang ZW; General Surgery Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310052, China.
  • Yu JD; Gastroenterology Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
  • Gao ZG; General Surgery Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310052, China. ebwk@zju.edu.cn.
  • Shu Q; General Surgery Department, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Binsheng Road 3333, Hangzhou, 310052, China. shuqiang@zju.edu.cn.
World J Pediatr ; 18(8): 538-544, 2022 08.
Article in English | MEDLINE | ID: covidwho-1906548
ABSTRACT

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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hepatitis Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Qualitative research / Reviews Limits: Child / Child, preschool / Humans Language: English Journal: World J Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12519-022-00581-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hepatitis Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Qualitative research / Reviews Limits: Child / Child, preschool / Humans Language: English Journal: World J Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12519-022-00581-x