Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Rassaei N [original query] |
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Acute liver failure and unique challenges of pediatric liver transplantation amidst a worldwide cluster of adenovirus-associated hepatitis
Banc-Husu AM , Moulton EA , Shiau H , Gutierrez Sanchez LH , Desai MS , Cerminara D , Munoz FM , Buffaloe LM , Valencia-Deray KG , Galvan NTN , Bhatnagar J , Estetter L , Rassaei N , Reagan-Steiner S , Wicker J , Dunn JJ , Allen CE , Patel KR , Harpavat S , Goss JA , Leung DH . Am J Transplant 2023 23 (1) 93-100 Investigation into a recent cluster of acute hepatitis in children from the southeastern United States identified human adenovirus (HAdV) DNAemia in all 9 cases. Molecular genotyping in 5 of 9 (56%) children identified HAdV type 41 in all cases (100%). Importantly, 2 children from this cluster progressed rapidly to pediatric acute liver failure (PALF) and required liver transplantation. HAdV type 41, a known cause of self-limited gastroenteritis, has not previously been associated with severe cholestatic hepatitis and liver failure in healthy children. Adenovirus polymerase chain reaction assay and sequencing of amplicons performed on DNA extracted from formalin-fixed, paraffin-embedded liver tissue also identified adenovirus species F (HAdV type 40 or 41) in these 2 children with PALF. Transplant considerations and successful liver transplantation in such situations remain scarce. In this report, we describe the clinical course, laboratory results, liver pathology, and treatment of 2 children with PALF associated with HAdV type 41, one of whom developed secondary hemophagocytic lymphohistiocytosis. Their successful posttransplant outcomes demonstrate the importance of early multidisciplinary medical management and the feasibility of liver transplantation in some children with PALF and HAdV DNAemia. |
A Case Series of Children with Acute Hepatitis and Human Adenovirus Infection.
GutierrezSanchez LH , Shiau H , Baker JM , Saaybi S , Buchfellner M , Britt W , Sanchez V , Potter JL , Ingram LA , Kelly D , Lu X , Ayers-Millsap S , Willeford WG , Rassaei N , Bhatnagar J , Bullock H , Reagan-Steiner S , Martin A , Rogers ME , Banc-Husu AM , Harpavat S , Leung DH , Moulton EA , Lamson DM , StGeorge K , Hall AJ , Parashar U , MacNeil A , Tate JE , Kirking HL . N Engl J Med 2022 387 (7) 620-630 BACKGROUND: Human adenoviruses typically cause self-limited respiratory, gastrointestinal, and conjunctival infections in healthy children. In late 2021 and early 2022, several previously healthy children were identified with acute hepatitis and human adenovirus viremia. METHODS: We used International Classification of Diseases, 10th Revision, codes to identify all children (<18 years of age) with hepatitis who were admitted to Children's of Alabama hospital between October 1, 2021, and February 28, 2022; those with acute hepatitis who also tested positive for human adenovirus by whole-blood quantitative polymerase chain reaction (PCR) were included in our case series. Demographic, clinical, laboratory, and treatment data were obtained from medical records. Residual blood specimens were sent for diagnostic confirmation and human adenovirus typing. RESULTS: A total of 15 children were identified with acute hepatitis - 6 (40%) who had hepatitis with an identified cause and 9 (60%) who had hepatitis without a known cause. Eight (89%) of the patients with hepatitis of unknown cause tested positive for human adenovirus. These 8 patients plus 1 additional patient referred to this facility for follow-up were included in this case series (median age, 2 years 11 months; age range, 1 year 1 month to 6 years 5 months). Liver biopsies indicated mild-to-moderate active hepatitis in 6 children, some with and some without cholestasis, but did not show evidence of human adenovirus on immunohistochemical examination or electron microscopy. PCR testing of liver tissue for human adenovirus was positive in 3 children (50%). Sequencing of specimens from 5 children showed three distinct human adenovirus type 41 hexon variants. Two children underwent liver transplantation; all the others recovered with supportive care. CONCLUSIONS: Human adenovirus viremia was present in the majority of children with acute hepatitis of unknown cause admitted to Children's of Alabama from October 1, 2021, to February 28, 2022, but whether human adenovirus was causative remains unclear. Sequencing results suggest that if human adenovirus was causative, this was not an outbreak driven by a single strain. (Funded in part by the Centers for Disease Control and Prevention.). |
Acute hepatitis and adenovirus infection among children-Alabama, October 2021-February 2022.
Baker Julia M, Buchfellner Markus, Britt William, Sanchez Veronica, Potter Jennifer L, Ingram L Amanda, Shiau Henry, Sanchez Luz Helena Gutierrez, Saaybi Stephanie, Kelly David, Lu Xiaoyan, Vega Everardo M, Ayers-Millsap Stephanie, Willeford Wesley G, Rassaei Negar, Bullock Hannah, Reagan-Steiner Sarah, Martin Ali, Moulton Elizabeth A, Lamson Daryl M, St George Kirsten, Parashar Umesh D, Hall Aron J, MacNeil Adam, Tate Jacqueline E, Kirking Hannah L . American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 2022 7 (7) 1919-1921 |
Acute hepatitis and adenovirus infection among children - Alabama, October 2021-February 2022
Baker JM , Buchfellner M , Britt W , Sanchez V , Potter JL , Ingram LA , Shiau H , GutierrezSanchez LH , Saaybi S , Kelly D , Lu X , Vega EM , Ayers-Millsap S , Willeford WG , Rassaei N , Bullock H , Reagan-Steiner S , Martin A , Moulton EA , Lamson DM , StGeorge K , Parashar UD , Hall AJ , MacNeil A , Tate JE , Kirking HL . MMWR Morb Mortal Wkly Rep 2022 71 (18) 638-640 During October-November 2021, clinicians at a children's hospital in Alabama identified five pediatric patients with severe hepatitis and adenovirus viremia upon admission. In November 2021, hospital clinicians, the Alabama Department of Public Health, the Jefferson County Department of Health, and CDC began an investigation. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy. |
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