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KMID : 0191120230380470401
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Journal of Korean Medical Science
2023 Volume.38 No. 47 p.401 ~ p.401
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A Report on a Nationwide Surveillance System for Pediatric Acute Hepatitis of Unknown Etiology in Korea
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Lee Kyung-Jae
Ko Jae-Sung
Park Kie-Young
Kang Ki-Soo
Lee Kun-Song
Hong Jea-Na
Kim Soon-Chul
Lee Yoon
Kang Ben
Kim Yu-Bin
Kim Hyun-Jin
Eun Byung-Wook
Cho Hye-Kyung
Kim Yae-Jean
Kim Mi-Jin
Lee Jin
Lee Taek-Jin
Oh Seak-Hee
Park So-Won
Hwang Eun-Ha
Sohn Sang-Jun
Lim Jin-Gyu
Kim Yoo-Jin
Lee Yeoun-Joo
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Abstract
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Background: Several cases of pediatric acute hepatitis of unknown etiology related to adenoviral infections have been reported in Europe since January 2022. The aim of this study was to compare the incidence, severity, possible etiology, and prognosis of the disease with those in the past in Korea.
Methods: The surveillance group collected data between May and November 2022 using a surveillance system. Acute hepatitis of unknown etiology was defined in patients aged < 16 years with a serum transaminase level > 500 IU/L, not due to hepatitis A-E or other underlying causes. For comparison, data from 18 university hospitals were retrospectively collected as a control group between January 2021 and April 2022.
Results: We enrolled 270 patients (mean age, 5 years). The most common symptom was fever. However, the incidence was similar between 2021 and 2022. Liver function test results, number of patients with acute liver failure (ALF), liver transplantation (LT), death, and adenovirus detection rates did not differ between the two groups. None of the adenovirus-positive patients in either group experienced ALF, LT, or death. In the surveillance group, adenovirus-associated virus-2 was detected in four patients, one of whom underwent LT. Patients with an unknown etiology showed significantly higher bilirubin levels, a lower platelet count, and a higher LT rate than patients with a possible etiology.
Conclusion: The incidence of pediatric acute hepatitis of unknown etiology and adenovirus detection rate have not increased in Korea.
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KEYWORD
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Hepatitis, Children, Adenovirus, Unknown Etiology
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