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Case report: A case of severe acute hepatitis of unknown origin

According to analyses of etiology, clinical features, diagnostic methods, and treatment strategies by summarizing a case of unexplained acute hepatitis recently experienced, we are aiming to provide some information to enrich the clinical experience in diagnosis and treatment of severe acute hepatit...

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Autores principales: Zhou, Yu-Jiao, Gu, Hui-Ying, Tang, Qi-Qin, Li, Fan, Zhu, Jin, Ai, Ting, Zhu, Kun, Xu, Bin-Yue, Wang, Qing, Huang, Ai-Long, Chen, Juan, Zhang, Zhen-Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579323/
https://www.ncbi.nlm.nih.gov/pubmed/36275068
http://dx.doi.org/10.3389/fped.2022.975628
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author Zhou, Yu-Jiao
Gu, Hui-Ying
Tang, Qi-Qin
Li, Fan
Zhu, Jin
Ai, Ting
Zhu, Kun
Xu, Bin-Yue
Wang, Qing
Huang, Ai-Long
Chen, Juan
Zhang, Zhen-Zhen
author_facet Zhou, Yu-Jiao
Gu, Hui-Ying
Tang, Qi-Qin
Li, Fan
Zhu, Jin
Ai, Ting
Zhu, Kun
Xu, Bin-Yue
Wang, Qing
Huang, Ai-Long
Chen, Juan
Zhang, Zhen-Zhen
author_sort Zhou, Yu-Jiao
collection PubMed
description According to analyses of etiology, clinical features, diagnostic methods, and treatment strategies by summarizing a case of unexplained acute hepatitis recently experienced, we are aiming to provide some information to enrich the clinical experience in diagnosis and treatment of severe acute hepatitis of unknown etiology in young children. A boy, aged 10 years and 6 months old, was admitted to the hospital due to acute abdominal pain, jaundice, and exceptionally high levels of ALT and AST. A range of measures, including patient history, physical examination, and routine laboratory testing, were performed. Furthermore, strategies such as trio-based next-generation sequencing (Trio-NGS) and liver biopsy, as well as metagenomic NGS (mNGS) of blood and liver samples were also performed. In summary, this case was an acute severe non-A–E hepatitis that is a probable case with hepatitis of unknown origin. Immunohistochemical analysis showed an immune injury in liver tissues. Torque teno virus (TTV) sequences were detected by mNGS assay. As for treatment strategies, in addition to general treatment, this patient also underwent plasmapheresis and methylprednisolone treatment due to disease deterioration. The patient’s liver function was improved afterward and discharged after one month of treatment. Taken together, this work reported the clinical feature and treatment of severe acute hepatitis with non-A–E hepatitis in detail. The potential mechanism of liver damage might be due to an immune attack in which TTV might play a role as a co-factor.
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spelling pubmed-95793232022-10-20 Case report: A case of severe acute hepatitis of unknown origin Zhou, Yu-Jiao Gu, Hui-Ying Tang, Qi-Qin Li, Fan Zhu, Jin Ai, Ting Zhu, Kun Xu, Bin-Yue Wang, Qing Huang, Ai-Long Chen, Juan Zhang, Zhen-Zhen Front Pediatr Pediatrics According to analyses of etiology, clinical features, diagnostic methods, and treatment strategies by summarizing a case of unexplained acute hepatitis recently experienced, we are aiming to provide some information to enrich the clinical experience in diagnosis and treatment of severe acute hepatitis of unknown etiology in young children. A boy, aged 10 years and 6 months old, was admitted to the hospital due to acute abdominal pain, jaundice, and exceptionally high levels of ALT and AST. A range of measures, including patient history, physical examination, and routine laboratory testing, were performed. Furthermore, strategies such as trio-based next-generation sequencing (Trio-NGS) and liver biopsy, as well as metagenomic NGS (mNGS) of blood and liver samples were also performed. In summary, this case was an acute severe non-A–E hepatitis that is a probable case with hepatitis of unknown origin. Immunohistochemical analysis showed an immune injury in liver tissues. Torque teno virus (TTV) sequences were detected by mNGS assay. As for treatment strategies, in addition to general treatment, this patient also underwent plasmapheresis and methylprednisolone treatment due to disease deterioration. The patient’s liver function was improved afterward and discharged after one month of treatment. Taken together, this work reported the clinical feature and treatment of severe acute hepatitis with non-A–E hepatitis in detail. The potential mechanism of liver damage might be due to an immune attack in which TTV might play a role as a co-factor. Frontiers Media S.A. 2022-10-05 /pmc/articles/PMC9579323/ /pubmed/36275068 http://dx.doi.org/10.3389/fped.2022.975628 Text en Copyright © 2022 Zhou, Gu, Tang, Li, Zhu, Ai, Zhu, Xu, Wang, Huang, Chen and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Zhou, Yu-Jiao
Gu, Hui-Ying
Tang, Qi-Qin
Li, Fan
Zhu, Jin
Ai, Ting
Zhu, Kun
Xu, Bin-Yue
Wang, Qing
Huang, Ai-Long
Chen, Juan
Zhang, Zhen-Zhen
Case report: A case of severe acute hepatitis of unknown origin
title Case report: A case of severe acute hepatitis of unknown origin
title_full Case report: A case of severe acute hepatitis of unknown origin
title_fullStr Case report: A case of severe acute hepatitis of unknown origin
title_full_unstemmed Case report: A case of severe acute hepatitis of unknown origin
title_short Case report: A case of severe acute hepatitis of unknown origin
title_sort case report: a case of severe acute hepatitis of unknown origin
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579323/
https://www.ncbi.nlm.nih.gov/pubmed/36275068
http://dx.doi.org/10.3389/fped.2022.975628
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