Case report: Severe acute hepatitis in a 22-month-old Chinese boy with Omicron sub-variant BA.2.38

Chen, Xinying; Hong, Junbin; Li, Yuxia; An, Caixia; Guo, Jianwen; Yang, Jinghua

doi:10.3389/fpubh.2022.1012638

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Lastly, the formation of gallstones leads to bile stasis, further causing liver damage (Trauner et al, 2008). Fortunately, due to the liver's exceptional regenerative and repair abilities (Fausto, 2000), along with hepatoprotective treatment with compound glycyrrhizin (Cao et al, 2006;Li et al, 2019;Chen et al, 2022), the child's liver function normalized approximately 1 month following the removal of these harmful factors and subsequent follow-up.…”

Section: Discussionmentioning

confidence: 99%

Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review

Tao,

Zhou,

Zheng

et al. 2024

Front. Pharmacol.

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Ceftriaxone is widely used in pediatric outpatient care for its efficacy against respiratory and digestive system infections, yet its increasing association with severe immune hemolytic reactions requires heightened vigilance from pediatricians. This report details a rare and severe case of ceftriaxone-induced severe immune hemolytic anemia (IHA), hemolytic crisis, myocardial injury, liver injury, renal calculi, and cholecystolithiasis in a previously healthy 3-year-old child. The child, treated for bronchitis, experienced sudden pallor, limb stiffness, and altered consciousness following the fifth day of ceftriaxone infusion, with hemoglobin (Hb) levels precipitously dropping to 21 g/L. Immediate cessation of ceftriaxone and the administration of oxygen therapy, blood transfusion, intravenous immunoglobulin (IVIG), and corticosteroids led to a gradual recovery. Despite initial improvements, the patient’s condition necessitated extensive hospital care due to complications including myocardial injury, liver injury, renal calculi, and cholecystolithiasis. After a 12-day hospital stay and a 3-month follow-up, the child showed complete normalization of Hb and liver function and resolution of calculi. In children, ceftriaxone infusion may trigger severe, potentially fatal, hemolytic reactions. Pediatricians must promptly recognize symptoms such as pallor, limb stiffness, and unresponsiveness, indicative of ceftriaxone-induced severe IHA, and immediately discontinue the drug. Effective management includes timely blood transfusion, respiratory support, IVIG administration, and corticosteroids when necessary, along with rigorous vital signs monitoring. Continued vigilance is imperative, even after cessation of ceftriaxone, to promptly address any residual adverse effects.

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Section: Discussionmentioning

confidence: 99%

Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review

Tao,

Zhou,

Zheng

et al. 2024

Front. Pharmacol.

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“…Moreover, several cases in the literature reported that some children with an asymptomatic or mild presentation of COVID-19 disease developed long COVID-19 liver manifestations, including acute liver failure or acute hepatitis cholestasis. The outcome varies widely from life-threatening and a need for liver transplant to total recovery after steroid treatment (17)(18)(19)(20). Reports in the literature on liver involvement in neonates with SARS-CoV-2 infection were sparse.…”

Section: Discussionmentioning

confidence: 99%

Case report: Acute hepatitis in neonates with COVID-19 during the Omicron SARS-CoV-2 variant wave: a report of four cases

Wang

et al. 2023

Front. Pediatr.

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BackgroundSevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), first emerging in December 2019 and continuously evolving, poses a considerable challenge worldwide. It was reported in the literature that neonates had mild upper respiratory symptoms and a better outcome after Omicron SARS-CoV-2 variant infection, but there was insufficient data about complications and prognosis.Case PresentationIn this paper, we present the clinical and laboratory characteristics of four COVID-19 neonate patients with acute hepatitis during the Omicron SARS-CoV-2 variant wave. All patients had a clear history of Omicron exposure and were infected via contact with confirmed caregivers. Low to moderate fever and respiratory symptoms were the primary clinical manifestations, and all patients had a normal liver function at the initial stage of the course. Then, the fever lasted 2 to 4 days, and it was noted that hepatic dysfunction might have occurred 5 to 8 days after the first onset of fever, mainly characterized by moderate ALT and AST elevation (>3 to 10-fold of upper limit). There were no abnormalities in bilirubin levels, blood ammonia, protein synthesis, lipid metabolism, and coagulation. All the patients received hepatoprotective therapy, and transaminase levels gradually decreased to the normal range after 2 to 3 weeks without other complications.ConclusionsThis is the first case series about moderate to severe hepatitis in COVID-19 neonatal patients via horizontal transmission. Besides fever and respiratory symptoms, the clinical doctor should pay much attention to evaluating the risk of liver function injury after SARS-CoV-2 variants infection, which is usually asymptomatic and has a delayed onset.

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Decreased NK cell count is a high-risk factor for convulsion in children with COVID-19

Shi,

Bian,

et al. 2023

BMC Infect Dis

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Background The neurological symptoms caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of increasing concern. Convulsions are among the main neurological manifestations reported in children with coronavirus disease-2019 (COVID-19), and cause serious harm to physical and mental health. This study aimed to investigate the risk factors for convulsion in children with COVID-19. Methods This prospective study was conducted at the Children’s Hospital of Soochow University. In total, 102 COVID-19 patients with convulsion, 172 COVID-19 patients without convulsion, and 50 healthy controls were enrolled in the study. The children’s clinical and laboratory data were analyzed to assess the risk factors for convulsion in COVID-19 patients. Results Convulsions occurred in 37.2% of children, mostly those aged 1–3 years, who were hospitalized with the Omicron variant. The neutrophil count, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) were significantly higher in the convulsion group than those in the non-convulsion and control groups (P < 0.01). However, the counts of lymphocytes, eosinophils, platelets, lymphocyte subsets, CD3+ T cells, CD4+ T cells, CD8+ T cells, and NK cells were lower in the convulsion group than those in the non-convulsion and control groups (P < 0.01). Multivariate regression analysis indicated that NK cell count (OR = 0.081, 95% CI: 0.010–0.652) and a history of febrile seizure (OR = 10.359, 95% CI: 2.115–50.746) were independent risk factors for the appearance of convulsions in COVID-19. Conclusions History of febrile seizure and decreased NK cell count were high-risk factors for convulsions in COVID-19 patients.

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Case report: Severe acute hepatitis in a 22-month-old Chinese boy with Omicron sub-variant BA.2.38

Cited by 3 publications

References 24 publications

Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review

Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review

Case report: Acute hepatitis in neonates with COVID-19 during the Omicron SARS-CoV-2 variant wave: a report of four cases

Decreased NK cell count is a high-risk factor for convulsion in children with COVID-19

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