Important expert warnings in the mysterious case of hepatitis in children

Both the European Center for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) have reported a sudden increase in hepatitis ‘including jaundice’, especially in children under 6 years of age. Warns of some signs in England and Europe and finally in Israel. In fact, it was announced that 8 children had liver transplants in England due to mysterious hepatitis. Association of Pediatric Gastroenterology, Hepatology and Nutrition Specialists. Dr. Esrat Polat noted that they have not yet received any such reports in Turkey, but in the case of jaundice whose cause is unknown, Kovid-19 should also be questioned.

Mysterious hepatitis cases in children, first reported in England, then in Denmark, Ireland, the Netherlands and Spain, and finally in the US and Israel, have raised concerns about a new global epidemic, with the European Center for Disease Prevention and Control (ECDC) and the World Health Organization The World Health Organization (WHO) later issued a statement. Eight children in England had to undergo a liver transplant due to unexplained acute hepatitis. The exact cause of hepatitis in children admitted to hospital with jaundice, diarrhea, vomiting and abdominal pain has not yet been determined, but research is ongoing to determine if it could occur, the agency said in a statement. Effects of previous Covid-19 infections. The ECDC statement, which drew attention to high liver enzyme values ​​in children with acute hepatitis, stated that no association was found with the Covid-19 vaccine and that hepatitis A, B, C, D and E type virus agents were not found in all cases. However, it was announced that 3 out of 13 cases reported from Scotland were positive for Covid-19 and two of them had Covid-19 infection in the last 3 months. In 5 cases, attention was drawn to adenovirus positivity, which causes seasonal epidemics.

Covid history should also be investigated in the January signs

University of Health Sciences Professor Dr. providing information about hepatitis caused by the virus. Dr. Ilhan Varangka Training and Research Hospital Pediatric Gastroenterology, Hepatology and Nutrition Specialists Association. Dr. Esra Polat said the history of covid should also be investigated in pediatric patients with diarrhea, vomiting, jaundice and elevated liver enzymes. Assoc. Dr. To treat Covid itself and other viral infections, which are quite common in children during these months, without causing permanent liver damage, families should be alert to the symptoms and consult a doctor, especially if jaundice is present, Polat said. Assoc. Dr. Polat, ‘Hepatitis cases have increased in England, the cause of which has not been determined recently, especially those with jaundice. These unknown cases have become alarming in the UK and research is ongoing. However, they do not know the reason yet. As we all know, there are many causes that can cause jaundice or inflammation of the liver. He said that viral infection is one of them.

Virus infections can lead to liver transplants

Assoc. Dr. Polat says that in viral infections, in addition to the hepatitis virus, that is, viruses that have a specific effect on the liver, many viruses can also infect the liver and cause a process that can lead from advanced liver infection (common hepatitis) to advanced hepatitis. It even causes organ failure and leads to liver transplantation. Mentioning this, he said: ‘One of the causes is Kovid-19 infection. We have learned a lot since the coronavirus came into our lives. We have seen that the liver is involved, especially in cases of coronavirus. Until September 2020, we encountered a different disease that developed after the coronavirus. It is MIS-C infection, meaning multi-inflammatory syndrome. MIS-C seen in children was very noisy in many patients. We also had patients we followed here and gave long-term treatment in the intensive care unit. We have detected abnormalities in liver enzyme values ​​in covid infection, during MIS-C infection. However, we found that the liver quality of these patients also improved with infection control.

Liver complaints without symptoms have been identified

Note that since 2021, there have been cases of Kovid-19 in the literature that show no signs of shortness of breath and appear only in the form of hepatitis, Assoc. Dr. Polat, ‘Very few, have limited case studies. The latest 4 cases have been made. Patients have no symptoms of shortness of breath. Her clinic was published only with advanced liver enzymes. It didn’t take them long to recover from their follow-up, but it was probably just the beginning. We do not know. Because after all, we still know and learn about this virus for over two years. Currently, we do not have a case that we have identified that we see this way. However, we must be careful to screen patients who have no respiratory symptoms but some symptoms of the gastrointestinal tract, who have jaundice, and who have improved liver function, in terms of covid.

If the eyes are black, diarrhea, vomiting, a doctor should be consulted

As well as warning families, the association said. Dr. Polat, ‘We especially want it from the family. Be careful in case of infection. Their children should pay attention to the color, not just a common cold, sore throat, cough, with complaints like stomach ache, diarrhea, vomiting which may be related to gastroenteritis (gastrointestinal infection). This type of infection can cause yellowing, especially of the eyes. Be sure to consult a doctor. Because early diagnosis is always important to us. During the Kovid epidemic, we found that the infection was actually a little milder in children than in adults. In fact, most of the time, if they are not tested within this period, they may not even realize it. They may not know they have been infected. When we evaluate patients (with liver symptoms), we must ask about the recent family history of Covid. This is because recent covid infections can cause elevated liver enzymes and unexplained jaundice.

Kovid should be added to the list of suspicious as well as other viruses

Note that hepatitis has many causes, in addition to viral infections it can also be caused by bacterial infections, but in most cases the hepatitis A, B, C, D and E viruses affect the liver, Assoc. Dr. In addition to these, some seasonal viruses can also cause hepatitis, Polat said. Assoc. Dr. Polat concludes with the following information: ‘We can list many factors, especially viral and bacterial agents. However, we see viral infections more frequently. We often get hepatitis A during childhood. This is because hepatitis A can be accompanied by an acute (sudden) infection, a very noisy picture, and the patient may have elevated liver enzyme levels and very severe jaundice. With treatment, the patient recovers in a short time, but it is found that these infections progress very quickly and result in very fatal (death) results, although this is rare. Also, viral agents that can cause upper respiratory tract infections such as cytomegalovirus (CMV), adenovirus (ADV), Epstein-Barr virus (EBV), but also increase liver enzymes and enlarge the liver and spleen, may also be encountered. In addition to the causes of this infection we have to be careful not to miss the covid infection. Taking a detailed anamnesis (history of the patient) in terms of coronavirus and performing necessary tests for the patient.

Demirören News Agency / Current

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