Theories emerge about mysterious liver diseases in children

Theories emerge about mysterious liver diseases in children – Mail Bonus

Health authorities are still at a loss as to the mysterious cases of severe liver damage in hundreds of young children around the world. The best available evidence points to a fairly common gastrointestinal disorder that is not known to cause liver problems in otherwise healthy children. This virus was found in the blood of sick children but – strangely enough – it has not been found in their infected liver.

“There are many things that do not make sense,” said Eric Kremer, a virologist at the Montpellier Molecular Genetics Institute in France.

When health authorities in more than a dozen countries look into the mystery, they ask:

  • Has there been an increase in gastric ulcer – called adenovirus 41 – that causes more cases of previously undiagnosed problems?
  • Are children more susceptible to epidemic-related closures that protected them from viruses that children normally experience?
  • Is there a mutated version of adenovirus that causes this? Or any other unknown pathogen, drug or toxin?
  • Is it some kind of response to the immune system that triggers the previous COVID-19 infection and the subsequent invasion of another virus?

US Centers for Disease Control and Prevention and researchers around the world are trying to figure out what’s going on.

The diseases are considered rare. CDC officials last week said they were now examining 180 possible cases across the United States. Most of the children were hospitalized, at least 15 needed a liver transplant and six died.

More than 20 other countries have reported hundreds of more cases in total, though most were in the UK and US

Symptoms of hepatitis – or hepatitis – include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light stools, joint pain and jaundice.

The extent of the problem first began to emerge last month, although pathologists say they have been working on the mystery for months. It has been insanely difficult to find a case, experts say.

Conventional causes of hepatitis in otherwise healthy children – the viruses known as hepatitis A, B, C, D and E – were not detected in the tests. What’s more, the kids came from different places and there didn’t seem to be any common exposures.

The finding was adenovirus 41. More than half of the cases in the United States have been positive for adenovirus, of which dozens are variants. In a few samples that were tested to see what kind of adenovirus was present, adenovirus 41 appeared each time.

The fact that adenovirus continues to appear strengthens the argument that it plays a role, but it is unclear how, said Dr. Jay Butler, Vice President of the CDC for Infectious Diseases, at the Associated Press.

Many glandular viruses are associated with common cold symptoms, such as fever, sore throat and pink eye. Some versions – including adenovirus 41 – can cause other problems, including inflammation of the stomach and intestines. Lymphoma has previously been linked to hepatitis in children, but mainly in children with weakened immune systems.

A recent genetic analysis has not revealed any evidence that one new mutated version of the virus is to blame, said Dr. Umesh Parashar, head of the CDC group that focuses on intestinal viral diseases.

Lymphoma infections are not systematically traced in the United States, so it is not clear if there has been any recent increase in viral activity. In fact, adenoviruses are so common that scientists are not sure what to do about their presence in these cases.

“If we start testing everyone for the glandular virus, they will find so many children who have it,” he said. Heli Bhatt, a pediatric gastroenterologist who treated two children in Minnesota with liver problems.

One was a child who came in almost five months ago with liver failure. Doctors could not understand why. Unfortunately, “not having a cause is something that happens,” Bhatt said. About a third of acute liver failure cases are unexplained, experts have estimated.

Bhatt said the second child she saw fell ill last month. At that time, the health authorities had been raising awareness of the situation and she and other doctors began to return and examine unexplained diseases since October.

In fact, many cases that were added to the number in recent weeks were not recent illnesses but previous ones that were reassessed. About 10% of cases in the United States occurred in May, Butler said. The exchange rate appears to be relatively flat since last autumn, he added.

It is possible that doctors are just discovering a phenomenon that has been going on for years, some scientists said.

Other possible explanation: COVID-19.

The CDC recently estimated that as of February, 75% of American children had been infected with the coronary heart disease virus.

Only 10% to 15% of children with mysterious hepatitis had COVID-19, according to dehydration tests given when they were admitted to hospital, health officials say.

However, researchers are considering previous coronavirus infections. It is possible that coronary heart disease hidden in the gut plays a role, said Petter Brodin, a pediatric immunologist at Imperial College London.

In an article earlier this month in the medical journal Lancet, Brodin and another scientist said that a combination of chronic coronary heart disease and adenovirus infection could trigger a liver-damaging immune response.

“I think this is an unfortunate combination of circumstances that could explain this,” Brodin told the Associated Press.

Butler said scientists have seen complex reactions like this before, and researchers are discussing ways to better examine the hypothesis.

He said it was “not at all out of credibility.”

The yet-to-be-revised case study of Case Western Reserve University indicated that children with COVID-19 were at significantly higher risk of liver damage.

Dr. Markus Buchfellner, pediatric infectious disease specialist at the University of Alabama at

took part in identifying the first US cases this fall.

The illness was “strange” and worrying, he said. Six months later, “we do not really know exactly what we are dealing with.”

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