Clinical Aspects and Etiologic Investigation of Pediatric Patients With Acute Liver Failure

Michele Luglio; Tatiana de Carvalho Silva Marques; Maria Fernanda Badue Pereira; Artur Figueiredo Delgado; Werther Brunow de Carvalho; Ana Cristina Aoun Tannuri; Natascha Silva Sandy; Nadia Litvinov; Camila Sanson Yoshino de Paula; Ariane Guissi Dos Santos; Carolina Dos Santos Lazari; Michele Soares Gomes Gouvea; Anderson Vicente de Paula; Tania Regina Tozetto Mendoza; Ryan Yukimatsu Tanigawa; Fabiana Roberto Lima; André Bubna Hirayama; Isabela Gusson Galdino Dos Santos; João Renato Rebello Pinho; Ester Cerdeira Sabino; Maria Cassia Mendes-Correah; Venancio Avancini Ferreira Alves; Heloisa Helena de Sousa Marques

doi:10.1016/j.transproceed.2023.08.004

Clinical Aspects and Etiologic Investigation of Pediatric Patients With Acute Liver Failure

Transplant Proc. 2023 Nov;55(9):2121-2125. doi: 10.1016/j.transproceed.2023.08.004. Epub 2023 Sep 26.

Authors

Michele Luglio¹, Tatiana de Carvalho Silva Marques², Maria Fernanda Badue Pereira³, Artur Figueiredo Delgado², Werther Brunow de Carvalho², Ana Cristina Aoun Tannuri⁴, Natascha Silva Sandy⁵, Nadia Litvinov³, Camila Sanson Yoshino de Paula³, Ariane Guissi Dos Santos³, Carolina Dos Santos Lazari⁶, Michele Soares Gomes Gouvea⁷, Anderson Vicente de Paula⁷, Tania Regina Tozetto Mendoza⁷, Ryan Yukimatsu Tanigawa⁸, Fabiana Roberto Lima⁸, André Bubna Hirayama⁸, Isabela Gusson Galdino Dos Santos⁴, João Renato Rebello Pinho⁷, Ester Cerdeira Sabino⁷, Maria Cassia Mendes-Correah⁷, Venancio Avancini Ferreira Alves⁸, Heloisa Helena de Sousa Marques³

Affiliations

¹ Instituto da Criança e do Adolescente do Hospital das Clínicas da FMUSP, São Paulo, Brazil; Pediatric Intensive Care Center, Instituto da Criança e do Adolescente da Faculdade de Medicina da Universidade de São Paulo. Electronic address: michele.luglio@hc.fm.usp.br.
² Pediatric Intensive Care Center, Instituto da Criança e do Adolescente da Faculdade de Medicina da Universidade de São Paulo.
³ Pediatric Infectology Department, Instituto da Criança e do Adolescente da Faculdade de Medicina da Universidade de São Paulo.
⁴ Pediatric Surgery and Liver Transplantion Department, Instituto da Criança e do Adolescente da Faculdade de Medicina da Universidade de São Paulo.
⁵ Pediatric Hepatology Departament, Instituto da Criança e do Adolescente da Faculdade de Medicina da Universidade de São Paulo.
⁶ Central Laboratory, Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
⁷ Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo.
⁸ Department of Pathology, Surgical Pathology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.

PMID: 37758563
DOI: 10.1016/j.transproceed.2023.08.004

Abstract

A new outbreak of hepatitis of unknown origin raised awareness in the international community. A few reports have attempted to associate new cases with adenovirus infection and the immunologic effects of previous SARS-CoV-2 infections through a superantigen mechanism. Moreover, according to a case series, viral isolates were identified in 7 of 10 cases of pediatric patients with hepatitis of unknown origin and acute liver failure. Adenovirus was detected by respiratory secretion polymerase chain reaction in 2 patients, with neither presenting with SARS-CoV-2 acute infection. Clinical and laboratory descriptions and cross-referencing epidemiologic and pathophysiological data can help identify possible disease etiologies.

MeSH terms

COVID-19* / complications
Child
Hepatitis*
Humans
Liver Failure, Acute* / diagnosis
Liver Failure, Acute* / etiology
Polymerase Chain Reaction
SARS-CoV-2