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. 2024 Apr 19;12(4):826.
doi: 10.3390/microorganisms12040826.

Acute Hepatitis of Unknown Origin in Children: Analysis of 17 Cases Admitted to the Bambino Gesù Children's Hospital in Rome

Velia Chiara Di Maio  1 , Leonarda Gentile  1 , Rossana Scutari  2 , Luna Colagrossi  1 , Luana Coltella  1 , Stefania Ranno  1 , Giulia Linardos  1 , Daniela Liccardo  3 , Maria Sole Basso  3 , Andrea Pietrobattista  3 , Simona Landi  1 , Lorena Forqué  1 , Marta Ciofi Degli Atti  4 , Lara Ricotta  5 , Andrea Onetti Muda  6 , Giuseppe Maggiore  3 , Massimiliano Raponi  5 , Carlo Federico Perno  1 , Cristina Russo  1
Affiliations

Acute Hepatitis of Unknown Origin in Children: Analysis of 17 Cases Admitted to the Bambino Gesù Children's Hospital in Rome

Velia Chiara Di Maio et al. Microorganisms. .

Abstract

This study described 17 cases of children admitted to the Bambino Gesù Children's Hospital with acute hepatitis of unknown origin between mid-April and November 2022. Following the World Health Organization's working case definition of probable cases, 17 children, with a median age of 2.1 years (interquartile range: 1.0-7.1), presenting with acute hepatitis non-AE, with serum transaminase >500 IU/L, were included in the study. A pre-specified set of microbiological tests was performed on different biological specimens for all pediatric patients. All patients resulted negative for the common hepatotropic viruses. The most common pathogen detected in blood specimens was human-herpes-virus-7 (52.9%). Adenovirus was detected more frequently in stool specimens (62.5%) than in respiratory (20.0%) or blood samples (17.6%). Regarding Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, one child tested positive two days after admission, while antibodies against spike and nucleoprotein were present in 82.3% of patients. A co-pathogen detection was observed in 94.1% of children. Overall, 16 children recovered without clinical complications, while one patient required liver transplantation. In these cases of acute hepatitis of unknown origin, adenovirus was mainly detected in stool samples. A co-pathogen detection was also frequently observed, suggesting that the etiology of this acute hepatitis is most probably multifactorial.

Keywords: acute hepatitis; adenovirus; pediatric.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Results related to laboratory investigations performed following the recommendations from the European Center for Disease Prevention and Control (ECDC). The graph in (A) shows serologic and RT-PCR results related to the investigation on common viruses that cause acute viral hepatitis (hepatitis viruses A, B, C, D, and E). The graph in (B) shows results related to serology for all the other viruses investigated.
Figure 1
Figure 1
Results related to laboratory investigations performed following the recommendations from the European Center for Disease Prevention and Control (ECDC). The graph in (A) shows serologic and RT-PCR results related to the investigation on common viruses that cause acute viral hepatitis (hepatitis viruses A, B, C, D, and E). The graph in (B) shows results related to serology for all the other viruses investigated.
Figure 2
Figure 2
Results related to laboratory investigations performed in different specimen typed (blood, stool, nasopharyngeal aspirate, or nasopharyngeal swab) using real-time PCR test for the 17 patients with acute hepatitis of unknown origin. The prevalence of positive and negative samples was calculated on the total of samples tested for each pathogen.
See this image and copyright information in PMC

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