"Parvovirus B19 相关急性肝炎:儿童的临床表现和预后"

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Arghya Samanta , Anshu Srivastava , Sangram S. Patel , Moinak Sen Sarma , Ujjal Poddar , Prabhakar Mishra
{"title":"\"Parvovirus B19 相关急性肝炎:儿童的临床表现和预后\"","authors":"Arghya Samanta ,&nbsp;Anshu Srivastava ,&nbsp;Sangram S. Patel ,&nbsp;Moinak Sen Sarma ,&nbsp;Ujjal Poddar ,&nbsp;Prabhakar Mishra","doi":"10.1016/j.jceh.2024.102416","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/Aims</h3><div>Acute liver injury is a common manifestation of parvovirus B19 (PVB19) infection in immunocompromised patients. However, literature in immunocompetent children is scarce. We aimed to study the clinicolaboratory features and outcome of hepatic involvement by PVB19 infection in hospitalized children.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed our prospectively kept database of all children (&lt;18 years old) admitted with acute viral hepatitis (AVH), acute liver failure (ALF) or acute-on-chronic liver failure (ACLF), and PVB19 infection between January 2010 and December 2023. Clinical features, laboratory parameters, and complications were evaluated. Poor outcome was defined as death or liver transplantation.</div></div><div><h3>Results</h3><div>A total of 35 children (19 boys [54%], median age: 7.25 [interquartile range: 4–10.8] years) with PVB19-related hepatitis were studied (28 [80%] isolated PVB19 infection and 7 [20%] coinfections [3 with Epstein–Barr virus, 2 with hepatitis A, and 1 each with hepatitis-E and cytomegalovirus]). AVH (17, 49%) was the most common presentation, followed by ALF (13, 37%) and acute insult in ACLF (5, 14%). Patients with coinfection had significantly higher bilirubin (14.6 [9.4–21.5] vs 6.8 [4.3–10.9] mg/dl; <em>P</em>=0.004) and transaminases (ALT: 697 [428–1296] vs. 277 [157–478] U/L; <em>P</em>=0.02) but similar mortality (1/7 vs 6/23; <em>P</em>=1.0) than PVB19 alone. Nine cases (25.7%) had extrahepatic complications (hemophagocytic lymphohistiocytosis [HLH]: 3, acute kidney injury: 3, aplastic anemia: 2, and myocarditis: 1). Poor outcome occurred in 38% (5/13) ALF, 11.7% (2/17) AVH (HLH: 1, myocarditis: 1), and none (0/5) of the ACLF cases.</div></div><div><h3>Conclusion</h3><div>PVB19 should be considered in children presenting with indeterminate acute liver injury, especially in younger children or those with complications such as aplastic anemia, HLH, or myocarditis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102416"},"PeriodicalIF":3.3000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"“Parvovirus B19–related Acute Hepatitis: Clinical Spectrum and Outcome in Children”\",\"authors\":\"Arghya Samanta ,&nbsp;Anshu Srivastava ,&nbsp;Sangram S. Patel ,&nbsp;Moinak Sen Sarma ,&nbsp;Ujjal Poddar ,&nbsp;Prabhakar Mishra\",\"doi\":\"10.1016/j.jceh.2024.102416\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background/Aims</h3><div>Acute liver injury is a common manifestation of parvovirus B19 (PVB19) infection in immunocompromised patients. However, literature in immunocompetent children is scarce. We aimed to study the clinicolaboratory features and outcome of hepatic involvement by PVB19 infection in hospitalized children.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed our prospectively kept database of all children (&lt;18 years old) admitted with acute viral hepatitis (AVH), acute liver failure (ALF) or acute-on-chronic liver failure (ACLF), and PVB19 infection between January 2010 and December 2023. Clinical features, laboratory parameters, and complications were evaluated. Poor outcome was defined as death or liver transplantation.</div></div><div><h3>Results</h3><div>A total of 35 children (19 boys [54%], median age: 7.25 [interquartile range: 4–10.8] years) with PVB19-related hepatitis were studied (28 [80%] isolated PVB19 infection and 7 [20%] coinfections [3 with Epstein–Barr virus, 2 with hepatitis A, and 1 each with hepatitis-E and cytomegalovirus]). AVH (17, 49%) was the most common presentation, followed by ALF (13, 37%) and acute insult in ACLF (5, 14%). Patients with coinfection had significantly higher bilirubin (14.6 [9.4–21.5] vs 6.8 [4.3–10.9] mg/dl; <em>P</em>=0.004) and transaminases (ALT: 697 [428–1296] vs. 277 [157–478] U/L; <em>P</em>=0.02) but similar mortality (1/7 vs 6/23; <em>P</em>=1.0) than PVB19 alone. Nine cases (25.7%) had extrahepatic complications (hemophagocytic lymphohistiocytosis [HLH]: 3, acute kidney injury: 3, aplastic anemia: 2, and myocarditis: 1). Poor outcome occurred in 38% (5/13) ALF, 11.7% (2/17) AVH (HLH: 1, myocarditis: 1), and none (0/5) of the ACLF cases.</div></div><div><h3>Conclusion</h3><div>PVB19 should be considered in children presenting with indeterminate acute liver injury, especially in younger children or those with complications such as aplastic anemia, HLH, or myocarditis.</div></div>\",\"PeriodicalId\":15479,\"journal\":{\"name\":\"Journal of Clinical and Experimental Hepatology\",\"volume\":\"15 1\",\"pages\":\"Article 102416\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical and Experimental Hepatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0973688324010831\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical and Experimental Hepatology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0973688324010831","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景/目的急性肝损伤是免疫功能低下患者感染 parvovirus B19 (PVB19) 后的常见表现。然而,有关免疫功能正常儿童的文献却很少。我们对 2010 年 1 月至 2023 年 12 月期间因急性病毒性肝炎(AVH)、急性肝功能衰竭(ALF)或急性慢性肝功能衰竭(ACLF)和 PVB19 感染入院的所有儿童(18 岁)的前瞻性数据库进行了回顾性分析。对临床特征、实验室参数和并发症进行了评估。结果 共研究了 35 名患有 PVB19 相关肝炎的儿童(19 名男孩 [54%],中位年龄:7.25 [四分位距:4-10.8] 岁)(28 名 [80%] 单独感染 PVB19,7 名 [20%] 合并感染 [3 名感染 Epstein-Barr 病毒,2 名感染甲型肝炎,1 名感染戊型肝炎和巨细胞病毒])。最常见的表现是 AVH(17 例,占 49%),其次是 ALF(13 例,占 37%)和 ACLF 中的急性损伤(5 例,占 14%)。合并感染的患者胆红素(14.6 [9.4-21.5] vs 6.8 [4.3-10.9] mg/dl;P=0.004)和转氨酶(ALT:697 [428-1296] vs 277 [157-478] U/L;P=0.02)明显高于单独感染 PVB19 的患者,但死亡率相似(1/7 vs 6/23;P=1.0)。九例患者(25.7%)出现肝外并发症(嗜血细胞性淋巴组织细胞增多症[HLH]:3例,急性肾损伤3例,再生障碍性贫血:2例,心肌炎:1例)。38%的ALF病例(5/13)、11.7%的AVH病例(2/17)(HLH:1例,心肌炎:1例)以及无ACLF病例(0/5)出现不良预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
“Parvovirus B19–related Acute Hepatitis: Clinical Spectrum and Outcome in Children”

Background/Aims

Acute liver injury is a common manifestation of parvovirus B19 (PVB19) infection in immunocompromised patients. However, literature in immunocompetent children is scarce. We aimed to study the clinicolaboratory features and outcome of hepatic involvement by PVB19 infection in hospitalized children.

Methods

We retrospectively analyzed our prospectively kept database of all children (<18 years old) admitted with acute viral hepatitis (AVH), acute liver failure (ALF) or acute-on-chronic liver failure (ACLF), and PVB19 infection between January 2010 and December 2023. Clinical features, laboratory parameters, and complications were evaluated. Poor outcome was defined as death or liver transplantation.

Results

A total of 35 children (19 boys [54%], median age: 7.25 [interquartile range: 4–10.8] years) with PVB19-related hepatitis were studied (28 [80%] isolated PVB19 infection and 7 [20%] coinfections [3 with Epstein–Barr virus, 2 with hepatitis A, and 1 each with hepatitis-E and cytomegalovirus]). AVH (17, 49%) was the most common presentation, followed by ALF (13, 37%) and acute insult in ACLF (5, 14%). Patients with coinfection had significantly higher bilirubin (14.6 [9.4–21.5] vs 6.8 [4.3–10.9] mg/dl; P=0.004) and transaminases (ALT: 697 [428–1296] vs. 277 [157–478] U/L; P=0.02) but similar mortality (1/7 vs 6/23; P=1.0) than PVB19 alone. Nine cases (25.7%) had extrahepatic complications (hemophagocytic lymphohistiocytosis [HLH]: 3, acute kidney injury: 3, aplastic anemia: 2, and myocarditis: 1). Poor outcome occurred in 38% (5/13) ALF, 11.7% (2/17) AVH (HLH: 1, myocarditis: 1), and none (0/5) of the ACLF cases.

Conclusion

PVB19 should be considered in children presenting with indeterminate acute liver injury, especially in younger children or those with complications such as aplastic anemia, HLH, or myocarditis.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Clinical and Experimental Hepatology
Journal of Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.90
自引率
16.70%
发文量
537
审稿时长
64 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信