Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes
Background Acute hepatitis can occur in association with systemic diseases outside the liver. Acute severe hepatitis with markedly elevated transaminase levels following extrahepatic infection has been reported in children. However, research on this condition remains limited. This study aimed to inv...
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Korean Society of Critical Care Medicine
2025-02-01
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| Series: | Acute and Critical Care |
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| Online Access: | http://www.accjournal.org/upload/pdf/acc-000600.pdf |
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| author | Sanghoon Lee Young Ok Kim Seo-Hee Kim |
| author_facet | Sanghoon Lee Young Ok Kim Seo-Hee Kim |
| author_sort | Sanghoon Lee |
| collection | DOAJ |
| description | Background Acute hepatitis can occur in association with systemic diseases outside the liver. Acute severe hepatitis with markedly elevated transaminase levels following extrahepatic infection has been reported in children. However, research on this condition remains limited. This study aimed to investigate its etiology, clinical course, and outcomes. Methods We retrospectively reviewed data from 2013 to 2020 for children under 12 years old with elevated liver enzymes following systemic infection. Acute severe hepatitis was defined as serum transaminase levels exceeding 1,000 IU/L in the absence of underlying liver disease. We analyzed hepatitis-associated pathogens, liver enzyme trends, and factors influencing recovery. Results A total of 39 patients were included in this study. The most common age group was 7–12 months (54.8%), and 53.8% were male. Respiratory infections were the most common (61.5%), followed by gastrointestinal infections (23.1%), meningitis (10.3%), and urinary tract infections (5.1%). The median peak alanine transaminase (ALT) level was 1,515.8±424.2 IU/L, with a median time to peak ALT of 4.4±2.3 days from symptom onset. ALT levels normalized within 21 days in 71.2% of patients and within 28 days in 94.9%. Younger age was associated with delayed ALT normalization, whereas hepatoprotective agent use was associated with faster normalization. Conclusions Acute severe hepatitis can develop following respiratory and other systemic infections. Younger children were more susceptible and had a more prolonged disease course. |
| format | Article |
| id | doaj-art-ca9e005c0c554a878e08b26e712e9961 |
| institution | DOAJ |
| issn | 2586-6052 2586-6060 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj-art-ca9e005c0c554a878e08b26e712e99612025-08-20T03:02:10ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-02-0140112212710.4266/acc.0006001588Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomesSanghoon Lee0Young Ok Kim1Seo-Hee Kim2 Department of Pediatrics, Chonnam National University Children's Hospital, Gwangju, Korea Department of Pediatrics, Chonnam National University Children's Hospital, Gwangju, Korea Department of Pediatrics, Chonnam National University Children's Hospital, Gwangju, KoreaBackground Acute hepatitis can occur in association with systemic diseases outside the liver. Acute severe hepatitis with markedly elevated transaminase levels following extrahepatic infection has been reported in children. However, research on this condition remains limited. This study aimed to investigate its etiology, clinical course, and outcomes. Methods We retrospectively reviewed data from 2013 to 2020 for children under 12 years old with elevated liver enzymes following systemic infection. Acute severe hepatitis was defined as serum transaminase levels exceeding 1,000 IU/L in the absence of underlying liver disease. We analyzed hepatitis-associated pathogens, liver enzyme trends, and factors influencing recovery. Results A total of 39 patients were included in this study. The most common age group was 7–12 months (54.8%), and 53.8% were male. Respiratory infections were the most common (61.5%), followed by gastrointestinal infections (23.1%), meningitis (10.3%), and urinary tract infections (5.1%). The median peak alanine transaminase (ALT) level was 1,515.8±424.2 IU/L, with a median time to peak ALT of 4.4±2.3 days from symptom onset. ALT levels normalized within 21 days in 71.2% of patients and within 28 days in 94.9%. Younger age was associated with delayed ALT normalization, whereas hepatoprotective agent use was associated with faster normalization. Conclusions Acute severe hepatitis can develop following respiratory and other systemic infections. Younger children were more susceptible and had a more prolonged disease course.http://www.accjournal.org/upload/pdf/acc-000600.pdfchildhepatitisinfectionprognosis |
| spellingShingle | Sanghoon Lee Young Ok Kim Seo-Hee Kim Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes Acute and Critical Care child hepatitis infection prognosis |
| title | Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes |
| title_full | Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes |
| title_fullStr | Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes |
| title_full_unstemmed | Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes |
| title_short | Acute severe hepatitis in children following extrahepatic infection in South Korea: etiology, clinical course, and outcomes |
| title_sort | acute severe hepatitis in children following extrahepatic infection in south korea etiology clinical course and outcomes |
| topic | child hepatitis infection prognosis |
| url | http://www.accjournal.org/upload/pdf/acc-000600.pdf |
| work_keys_str_mv | AT sanghoonlee acuteseverehepatitisinchildrenfollowingextrahepaticinfectioninsouthkoreaetiologyclinicalcourseandoutcomes AT youngokkim acuteseverehepatitisinchildrenfollowingextrahepaticinfectioninsouthkoreaetiologyclinicalcourseandoutcomes AT seoheekim acuteseverehepatitisinchildrenfollowingextrahepaticinfectioninsouthkoreaetiologyclinicalcourseandoutcomes |