Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 24;11(2):302.
doi: 10.3390/microorganisms11020302.

Liver Transaminases in Pediatric Adenovirus Infection-A Five-Year Study in Two Major Reference Centers from Romania

Oana Săndulescu  1   2 , Anca Streinu-Cercel  1   2 , Victor Daniel Miron  1   3 , Silvia Mirela Covăcescu  1   3 , Adrian Streinu-Cercel  1   2 , Mihai Craiu  1   3
Affiliations

Liver Transaminases in Pediatric Adenovirus Infection-A Five-Year Study in Two Major Reference Centers from Romania

Oana Săndulescu et al. Microorganisms. .

Abstract

Human adenovirus causes infections with a very heterogeneous clinical picture, and children are often the most frequently affected group. Interest in adenovirus has increased with the 2022 outbreak of severe acute hepatitis of unknown etiology as human adenovirus was considered as one of the possible etiological agents. We conducted a retrospective study over a 5-year period in two major tertiary hospitals in the Romanian capital with the aim to characterize the clinical picture and the dynamics of liver function tests in children with confirmed adenovirus infection. The study included 1416 children with a median age of 1.1 years (IQR: 0.3, 2.3 years). Digestive symptoms were predominant in 95.2% of children, mainly diarrhea (90.5%) and vomiting (50.5%), and 38.0% had respiratory symptoms. Increased transaminases were identified in 21.5% of patients. Age over 1 year, lethargy, vomiting and dehydration significantly increased the odds of liver cytolysis independent of other risk factors such as chronic conditions or co-infections. Aspartate aminotransferase (AST) was more commonly increased compared to alanine aminotransferase (ALT). Only six children had transaminase increases above 500 U/L, three of which had co-infections with rotavirus, Epstein-Barr virus (EBV), or respiratory syncytial virus (RSV). Liver function tests should be part of routine monitoring for pediatric patients with adenovirus infection. The current study fills a gap in current knowledge related to the frequency and the extent of liver involvement in human adenovirus infection among pediatric patients.

Keywords: children; human adenovirus; liver cytolysis; transaminases.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of pediatric adenovirus cases per year.
Figure 2
Figure 2
Distribution of symptoms in pediatric patients with adenovirus infection.
Figure 3
Figure 3
Distribution of co-infections identified in pediatric patients with adenovirus infection.
Figure 4
Figure 4
Distribution of transaminases values in pediatric patients with adenovirus infection.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Emerging Pathogens Causing Acute Hepatitis.
    Sayed IM, El-Shamy A, Abdelwahab SF. Sayed IM, et al. Microorganisms. 2023 Dec 10;11(12):2952. doi: 10.3390/microorganisms11122952. Microorganisms. 2023. PMID: 38138096 Free PMC article.

References

    1. Marsh K., Tayler R., Pollock L., Roy K., Lakha F., Ho A., Henderson D., Divala T., Currie S., Yirrell D., et al. Investigation into cases of hepatitis of unknown aetiology among young children, Scotland, 1 January 2022 to 12 April 2022. Eurosurveillance. 2022;27:2200318. doi: 10.2807/1560-7917.ES.2022.27.15.2200318. - DOI - PMC - PubMed
    1. World Health Organization Acute Hepatitis of Unknown Aetiology—The United Kingdom of Great Britain and Northern Ireland 2022. [(accessed on 20 December 2022)]. Available online: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON368.
    1. Kelly D.A., Stamataki Z. Sudden onset hepatitis in children. Nat. Rev. Gastroenterol. Hepatol. 2022;19:553–554. doi: 10.1038/s41575-022-00652-4. - DOI - PMC - PubMed
    1. Robinson C.M., Seto D., Jones M.S., Dyer D.W., Chodosh J. Molecular evolution of human species D adenoviruses. Infect. Genet. Evol. 2011;11:1208–1217. doi: 10.1016/j.meegid.2011.04.031. - DOI - PMC - PubMed
    1. Arnold J., Jánoska M., Kajon A.E., Metzgar D., Hudson N.R., Torres S., Harrach B., Seto D., Chodosh J., Jones M.S. Genomic characterization of human adenovirus 36, a putative obesity agent. Virus Res. 2010;149:152–161. doi: 10.1016/j.virusres.2010.01.011. - DOI - PMC - PubMed

LinkOut - more resources