Overview
Acute severe hepatitis of unknown origin in children refers to a sudden and serious inflammation of the liver in young patients, without a known cause such as hepatitis A–E viruses. Since early 2022, clusters of such cases have been reported globally, raising public health concern due to the severity of illness and instances of liver failure requiring transplants.
Causes
The exact cause remains unidentified, but possible factors being investigated include:
- Adenovirus infection, particularly type 41, found in many affected children
- COVID-19 (SARS-CoV-2) co-infection or previous exposure
- Environmental toxins
- Autoimmune reactions
- Novel pathogens or genetic susceptibility
It is likely a combination of viral and host factors, although no definitive cause has been established.
Symptoms
Symptoms of acute severe hepatitis in children may include:
- Jaundice (yellowing of skin and eyes)
- Dark urine and pale stools
- Nausea and vomiting
- Fatigue and lethargy
- Abdominal pain
- Fever in some cases
In severe cases, symptoms of acute liver failure may develop, such as confusion, bleeding, or coma.
Diagnosis
Diagnosis involves ruling out known hepatitis viruses (A–E), as well as:
- Liver function tests (elevated ALT/AST levels)
- Coagulation profiles
- Imaging studies
- Tests for adenovirus, COVID-19, and other infections
- Liver biopsy in some cases
Treatment
There is no specific antiviral treatment for this condition due to the unknown cause. Management is supportive and may include:
- Intravenous fluids and nutrition
- Medications to manage symptoms (e.g., antiemetics)
- Monitoring and treatment of liver function and clotting
- Intensive care for children with liver failure
- Liver transplantation in severe cases
Prevention
Since the exact cause is not known, general preventive measures include:
- Good hand hygiene
- Avoiding close contact with sick individuals
- Safe food and water consumption
- Keeping up with vaccinations
- Monitoring for early symptoms and seeking prompt medical care
Prognosis
Most children recover with supportive care, but a small percentage may progress to acute liver failure. The prognosis depends on early recognition and access to advanced medical care, including transplantation if needed.