https://pubmed.ncbi.nlm.nih.gov/35848740/ hepatitis

J Pediatr Gastroenterol Nutr. 2022 Jul 18.
doi: 10.1097/MPG.0000000000003567.Online ahead of print.

Acute Hepatitis of Unknown Aetiology Among Young Children: Research Agenda by the ESPGHAN Hepatology Committee

Giuseppe Indolfi 1, Piotr Czubkowski 2, Emer Fitzpatrick 3, Emmanuel Gonzales 4, Girish Gupte 5, Sara Mancell 6, Yael Mozer-Glassberg 7, Emanuele Nicastro 8, Junge Norman 9, Xavier Stephenne 10, Aglaia Zellos 11, Marianne Samyn 6
Affiliations expand
PMID: 35848740

DOI: 10.1097/MPG.0000000000003567

Abstract

In April 2022, an increased incidence of acute hepatitis cases of unknown aetiology among previously healthy children across the United Kingdom was described. Since, more than 200 cases from United Kingdom and hundreds more from all across the world have been reported. The majority of affected children were younger than six years of age. The clinical presentation was nonspecific with diarrhoea and vomiting usually preceding the appearance of jaundice, abdominal pain, nausea and malaise. Approximately 10% have required liver transplantation. An infectious aetiology has been considered likely given the epidemiological and clinical features of the reported cases. More than 60% of the children tested were diagnosed with adenovirus infection although a clear aetiological connection has still to be demonstrated. No link with SARS-CoV-2 infection and COVID-19 vaccine was found. What is not clear to date is whether the high number of acute hepatitis cases reported is related to a true increase in incidence or heightened awareness following on from the initial reports from the United Kingdom. The Hepatology Committee of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition developed a paper on the current outbreak of acute hepatitis of unknown aetiology recognizing its importance and the need of approaching the current situation with a scientifically rigorous approach. The aims of the paper are to summarize the current knowledge and to identify the most pertinent issues regarding the diagnosis and management of this condition and the research questions raised.