The most common causes of acute hepatitis in children are hepatitis A and autoimmune hepatitis. Hepatitis in the course of Wilson’s disease is sporadically registered in adolescents.
An increase of activity of aminotransferases both in the course of multisystem inflammatory syndrome in children (MIS-C) and in the course of COVID-19 has been observed. Hepatitis is common in children with MIS-C and is associated with a more severe presentation and persistent elevation of liver function tests.
To date, no cases of acute hepatitis in children due to COVID-19 have been reported.
We present 2 cases of acute hepatitis in children where the only cause seems to be a previous asymptomatic SARS-CoV-2 infection.
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Cantor A, Miller J, Zachariah P, et al. Acute hepatitis is a prominent presentation of the multisystem inflammatory syndrome in children: a single-center report. Hepatology 2020; 72: 1522-1527.
Perez A, Cantor A, Rudolph, et al. Liver involvement in children with SARS-COV-2 infection: Two distinct clinical phenotypes caused by the same virus. Liver Int 2021; 41: 2068-2075.
Brisca G, Mallamaci M, Tardini G, et al. SARS-CoV-2 infection may present as acute hepatitis in children. Pediatr Infect Disease J 2021; 40: e214-e215.
Joint European Centre for Disease Prevention and Control (ECDC): World Health Organisation (WHO) Regional Office for Europe Hepatitis of Unknown Origin in Children Surveillance. Bulletin 2022.
Baker JM, Buchfellner M, Britt W. Acute hepatitis and adenovirus infection among children – Alabama, October 2021 – February 2022. Morb Mortal Wkly Rep 2022; 71: 638-640.
Nishiura H, Jung SM, Hayashi K. High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children. Int J Infect Dis 2022; 122: 30-32.
Ludvigsson JF. Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19. Acta Paediatr 2021; 110: 914-921.
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