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

作者全名："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"

作者地址："[Zhou, Yu-Jiao; Gu, Hui-Ying; Huang, Ai-Long; Chen, Juan] Chongqing Med Univ, Key Lab Mol Biol Infect Dis Designated, Chinese Minist Educ, Chongqing, Peoples R China; [Tang, Qi-Qin; Ai, Ting; Zhang, Zhen-Zhen] Chongqing Med Univ, Childrens Hosp, Dept Infect Dis, Minist Educ,Key Lab Child Dev & Disorders,Natl Cli, Chongqing, Peoples R China; [Li, Fan] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrine & Breast Surg, Chongqing, Peoples R China; [Zhu, Jin] Chongqing Med Univ, Childrens Hosp, Dept Pathol, Chongqing, Peoples R China; [Zhu, Kun] Chongqing Med Univ, Childrens Hosp, Dept Radiol, Chongqing, Peoples R China; [Xu, Bin-Yue; Wang, Qing] Chongqing Municipal Ctr Dis Control & Prevent, Chongqing, Peoples R China; [Chen, Juan] Chongqing Med Univ, Key Lab Lab Med Diagnost, Chinese Minist Educ, Chongqing, Peoples R China"

通信作者："Chen, J (通讯作者)，Chongqing Med Univ, Key Lab Mol Biol Infect Dis Designated, Chinese Minist Educ, Chongqing, Peoples R China.; Zhang, ZZ (通讯作者)，Chongqing Med Univ, Childrens Hosp, Dept Infect Dis, Minist Educ,Key Lab Child Dev & Disorders,Natl Cli, Chongqing, Peoples R China.; Chen, J (通讯作者)，Chongqing Med Univ, Key Lab Lab Med Diagnost, Chinese Minist Educ, Chongqing, Peoples R China."

来源：FRONTIERS IN PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000871321600001

JCR分区：Q1

影响因子：2.6

年份：2022

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：case report; unexplained acute hepatitis; torque teno virus; immune injury; methylprednisolone

摘要："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."

基金机构："Program for Youth Innovation in Future Medicine, Chongqing Medical University; Chongqing Natural Science Foundation; Medical Scientific Research Project of Chongqing; [cstc2021jcyj-msxmX0139]; [2021MSXM067]"

基金资助正文："Funding This study was supported by the Program for Youth Innovation in Future Medicine, Chongqing Medical University (Z-ZZ); Chongqing Natural Science Foundation (Grant no. cstc2021jcyj-msxmX0139 to Z-ZZ); and the Medical Scientific Research Project of Chongqing (Grant no. 2021MSXM067 to FL)."