Adenoviral Hepatitis in an Immunocompetent Child: Case report

Hamod, Dany Al

doi:10.15406/jpnc.2017.07.00290

Cited by 3 publications

(6 citation statements)

References 9 publications

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“…Наиболее опасна реактивация АДВ в раннем посттрансплантационном периоде (до +100-го дня), а при отсутствии ответа на лечение в период до 10-14 дней наступает гибель больного. В процессе нарастания клинической симптоматики отмечается присоединение новых зон поражения: паренхимы печени, [8,10,11]. Острая печеночная недостаточность аденовирусной этиологии в основном описана у иммунокомпрометированных пациентов и в большинстве случаев заканчивается летальным исходом [10,11].…”

Section: материалы и методыunclassified

“…В процессе нарастания клинической симптоматики отмечается присоединение новых зон поражения: паренхимы печени, [8,10,11]. Острая печеночная недостаточность аденовирусной этиологии в основном описана у иммунокомпрометированных пациентов и в большинстве случаев заканчивается летальным исходом [10,11]. Несмотря на свою редкость, аденовирусная печеночная недостаточность представляет диагностическую и терапевтическую проблему в связи с ее агрессивным клиническим течением и крайне плохим прогнозом.…”

Section: материалы и методыunclassified

“…Отрицательная культура АДВ в выделениях и ликворе не исключает наличия вируса из-за ограниченной чувствительности теста. С другой стороны, положительная вирусная культура не дает доказательств инвазионного или диссеминированного заболевания вследствие слущивания эпителиальных клеток, содержащих АДВ [3,7,10,11].…”

Section: материалы и методыunclassified

“…Кроме того, ПЦР необходима для обнаружения АДВ в биопсийных тканях [10]. Однако при массивном печеночном некрозе у пациентов с фульминантным печеночным аденовирусным гепатитом ДНК АДВ методом ПЦР в биопсийных тканях может быть отрицательной [10,11].…”

Section: материалы и методыunclassified

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Clinical case of curing a generalized adenovirus infection on the background of graft versus host reaction in a child after bone marrow transplantation from a haploidentical donor

Мезенцева

Скоробогатова

Буря

et al. 2019

Ross. ž. det. gematol. onkol.

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Adenovirus infection is one of the causes of transplant-associated mortality after allogeneic hematopoietic stem cell transplantation. Fulminant liver failure with adenovirus infection is a diagnostic and therapeutic problem due to its aggressive clinical course and extremely poor prognosis, while modern methods of treating adenovirus infection are based on the use of virostatic drugs and virus-specific lymphocytes and are associated with severe side effects. The article presents a rare clinical case of elimination of disseminated adenoviral infection with fulminantly developing liver failure in a patient after allogeneic bone marrow transplantation from a haploidentical donor.

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Section: материалы и методыunclassified

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Clinical case of curing a generalized adenovirus infection on the background of graft versus host reaction in a child after bone marrow transplantation from a haploidentical donor

Мезенцева

Скоробогатова

Буря

et al. 2019

Ross. ž. det. gematol. onkol.

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“…Only rare, sporadic cases of severe hepatitis associated with adenovirus in previously healthy children have been reported. [2][3][4][5] Since early 2022, there has been an increase in reports of pediatric acute hepatitis of unknown etiology, the majority of which occurred in the UK [6][7][8] and in Alabama 9,10 with evidence of concurrent adenovirus infection. The pressing concern relates to the underlying pathogenesis as to whether the severe liver damage was primarily due to active infection or immune-mediated attack triggered by pathogen exposures.…”

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confidence: 99%

Clinicopathologic Features of Severe Acute Hepatitis Associated With Adenovirus Infection in Children

Liang

Kelly²,

Pai

et al. 2023

American Journal of Surgical Pathology

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A recent increase in reports of severe acute hepatitis of unknown etiology in children is under investigation. Although adenovirus has been frequently detected, its role remains unclear, and systematic histopathologic analysis is lacking. We conducted a retrospective study of 11 children hospitalized between October 2021 and May 2022 with unexplained acute hepatitis and concurrent adenovirus infection. Liver biopsies collected shortly after admission demonstrated moderately to severely active hepatitis in 8/11 (73%) cases, characterized by marked portal mixed inflammation, moderate-to-severe interface activity, and milder lobular inflammation. Clusters of plasma cells were present in 6/11 (55%) cases, mimicking autoimmune hepatitis. Semiquantitative scoring of 17 discrete histologic features found that greater degrees of portal inflammation, interface activity, bile duct injury, bile ductular reaction, lobular inflammation, Kupffer cell activation, and hepatocyte focal necrosis were significantly more common in these cases in comparison to the control group of unexplained acute severe hepatitis without adenovirus infection. Liver biopsy immunohistochemistry was negative for adenovirus in all cases. Polymerase chain reaction testing of liver tissue was positive for the enteric adenovirus serotypes 41 (species F) in 10/11 (91%) cases. An immunoprofile study of hepatic infiltrating lymphocytes in 1 patient revealed the presence of large numbers of CD3+ and CD4+ lymphocytes. Nine patients received supportive treatment without steroids and recovered without the need for liver transplantation. In summary, liver injury in children with severe acute hepatitis and adenovirus infection is characterized by a hepatitic pattern that resembles severe autoimmune hepatitis and may represent an immune-mediated process associated with viral infection.

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Case report: A case of severe acute hepatitis of unknown origin

Zhou

Tang

et al. 2022

Front. Pediatr.

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According to analyses of etiology, clinical features, diagnostic methods, and treatment strategies by summarizing a case of unexplained acute hepatitis recently experienced, we are aiming to provide some information to enrich the clinical experience in diagnosis and treatment of severe acute hepatitis of unknown etiology in young children. A boy, aged 10 years and 6 months old, was admitted to the hospital due to acute abdominal pain, jaundice, and exceptionally high levels of ALT and AST. A range of measures, including patient history, physical examination, and routine laboratory testing, were performed. Furthermore, strategies such as trio-based next-generation sequencing (Trio-NGS) and liver biopsy, as well as metagenomic NGS (mNGS) of blood and liver samples were also performed. In summary, this case was an acute severe non-A–E hepatitis that is a probable case with hepatitis of unknown origin. Immunohistochemical analysis showed an immune injury in liver tissues. Torque teno virus (TTV) sequences were detected by mNGS assay. As for treatment strategies, in addition to general treatment, this patient also underwent plasmapheresis and methylprednisolone treatment due to disease deterioration. The patient’s liver function was improved afterward and discharged after one month of treatment. Taken together, this work reported the clinical feature and treatment of severe acute hepatitis with non-A–E hepatitis in detail. The potential mechanism of liver damage might be due to an immune attack in which TTV might play a role as a co-factor.

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Adenoviral Hepatitis in an Immunocompetent Child: Case report

Cited by 3 publications

References 9 publications

Clinical case of curing a generalized adenovirus infection on the background of graft versus host reaction in a child after bone marrow transplantation from a haploidentical donor

Clinical case of curing a generalized adenovirus infection on the background of graft versus host reaction in a child after bone marrow transplantation from a haploidentical donor

Clinicopathologic Features of Severe Acute Hepatitis Associated With Adenovirus Infection in Children

Case report: A case of severe acute hepatitis of unknown origin

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