May 2022 acute hepatitis outbreak,is there a role for COVID-19 and other viruses?  

作　　者：Reem Elbeltagi Mohammed Al-Beltagi Nermin Kamal Saeed Adel Salah Bediwy Osama Toema 

机构地区：[1]Department of Medicine,The Royal College of Surgeons in Ireland-Bahrain,Busiateen 15503,Muharraq,Bahrain [2]Department of Pediatrics,Faculty of Medicine,Tanta University,Tanta 31511,Al Gharbia,Egypt [3]Department of Pediatrics,University Medical Center,King Abdulla Medical City,Arabian Gulf University,Dr.Sulaiman Al Habib Medical Group,Manama 26671,Bahrain [4]Department of Pathology,Microbiology Section,Salmaniya Medical Complex,Manama 12,Bahrain [5]Department of Microbiology,Royal College of Surgeons in Ireland-Bahrain,Busaiteen 15503,Muharraq,Bahrain [6]Department of Chest Diseases,Faculty of Medicine,Tanta University,Tanta 31527,Al Gharbia,Egypt [7]Department of Chest Diseases,University Medical Center,King Abdulla Medical City,Arabian Gulf University,Dr.Sulaiman Al Habib Medical Group,Manama 26671,Bahrain

出　　处：《World Journal of Hepatology》2023年第3期364-376,共13页世界肝病学杂志（英文版）（电子版）

摘　　要：There has been an increasing number of reported cases of acute hepatitis of unknown origin in previously healthy children since first reported on March 31,2022.This clinical syndrome is identified by jaundice and markedly elevated liver enzymes with increased aspartate transaminase and/or alanine aminotransa-minase(greater than 500 IU/L).We conducted an inclusive literature review with respect to acute hepatitis outbreaks in children using the search terms acute hepatitis,outbreak,children,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),coronavirus disease 2019(COVID-19),and adenovirus.According to the cumulative data presented in four main studies,the median age is 4 years,with a male predominance(1.3:1).Jaundice was the most common clinical manifestation(69%),followed by vomiting(63%),anorexia(52.9%),diarrhea(47.2%),abdominal pain(39%),pyrexia(33.3%),pale stool(30%),and dark urine(30%).Coryza and lethargy were reported in 16.6%,while pruritus was reported in 2%of cases.Acute liver failure was observed in 25%of cases.The exact mechanism of this acute hepatitis outbreak is still not entirely clear.Adenoviruses and SARS-CoV-2 were detected in a significant number of patients.Coinfection with adenovirus and SARS-CoV-2 could be a possible underlying mechanism.However,other possible infections and mechanisms must be considered in the pathogenesis of this condition.Acute hepatitis of unknown origin in children has been a serious problem since the start of the COVID-19 pandemic but has not yet been sufficiently addressed.Many questions remain regarding the underlying mechanisms leading to acute liver failure in children,and it is likely that extensive future research is needed.

关 键 词：Acute hepatitis of unknown origin Children ADENOVIRUS SARS-CoV-2 COVID-19 Hepatic failure 

分 类 号：R575.1[医药卫生—消化系统] R181.3[医药卫生—内科学]