Investigations Spurred by Rare Liver Disease Detected in Children, Some Requiring Transplants

Cases of liver disease in children, including some reported to have required transplants, have spurred investigations in multiple regions of the world.

Here in the U.S., per a report from the Associated Press, nine such cases have been reported in Alabama. Affected children were as young as one and as old as six, with two confirmed to have required liver transplants. 

Health authorities in the state have been researching an uptick in hepatitis in this age group since November of last year. Oddly, each case ultimately saw the child testing positive for adenovirus. There were no reported underlying conditions in the children that would account for liver disease.

First to report on the U.S. cases was the health news publication Stat, who noted the Centers for Disease Control and Prevention (CDC) is working with Alabama officials in an investigation. Also mentioned is the involvement of other state authorities.

“CDC is working with state health departments to see if there are additional U.S. cases, and what may be causing these cases,” an agency rep said this week. “At this time adenovirus may be the cause for these, but investigators are still learning more—including ruling out the more common causes of hepatitis.”

Meanwhile, the World Health Organization (WHO) said Friday that it had been notified earlier this month of “10 cases of severe acute hepatitis of unknown aetiology in children under the age of 10 years, across central Scotland.” As of April 8, 74 cases had been reported in the U.K. According to the agency, hepatitis viruses have since been “excluded” by way of lab testing.

“Although the potential role of adenovirus and/or SARS-CoV-2 in the pathogenesis of these cases is one hypothesis, other infectious and non-infectious factors need to be fully investigated to properly assess and manage the risk,” WHO said in its latest statement.

Of those aforementioned cases, six required liver transplants. Who also pointed to reports of less than five “confirmed or possible” cases in Ireland, as well as three confirmed in Spain. Investigations are ongoing in both instances. Per the latest available info, no deaths have been reported.

Complex has reached out to reps for the Alabama Department of Public Health and the CDC for additional comment.