SEARCHCASE_REPORTpediatric ophthalmology, gastroenterology

case_report·pediatric ophthalmology, gastroenterology, pediatrics, infectious disease, critical care·PMC10191572

Acute Liver Failure in a Healthy Young Female With COVID-19

JPGN Reports · 14 authors, 7 centres

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TL;DR

A 15-year-old girl with no pulmonary symptoms developed acute liver failure associated with COVID-19; liver biopsy showed submassive necrosis with in situ-hybridization and immunohistochemistry confirming replicating SARS-CoV-2 RNA in hepatocytes.

Full summary

883 CHARS

A 15-year-old girl presented with anosmia, ageusia, nausea, vomiting, and no pulmonary symptoms, with confirmed SARS-CoV-2 exposure. She developed ALF on hospital day 2, and extensive etiologic testing was unrevealing. Treatment included vitamin K, broad-spectrum antibiotics, lactulose, rifaximin, dexamethasone, CRRT for hyperammonemia, N-acetyl cysteine, and compassionate-use casirivimab/imdevimab on HD5. She improved on HD6 and was extubated on HD7. Liver biopsy on HD15 showed acute hepatitis with submassive centrilobular necrosis. In situ-hybridization detected replicating SARS-CoV-2 RNA in hepatocytes, and immunostaining confirmed nucleocapsid protein expression. She was discharged on HD16 with normal liver tests at 5 months. The authors noted a temporal association between monoclonal antibody administration and clinical improvement but could not establish causality.

STUDY TYPE

case_report

SPECIALTY

pediatric ophthalmology

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10191572

Acute Liver Failure in a Healthy Young Female With COVID-19

JPGN Reports

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ABSTRACT

Abstract Several well-described manifestations of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported. Among them, a transient elevation of liver enzymes is the typical presentation of coronavirus disease 2019 (COVID-19) liver-related injury. The mechanism of liver involvement is likely a combination of viral injury and immune-mediated inflammation. In contrast, acute liver failure in the setting of COVID-19 has rarely been reported. Herein, we report a case of pediatric acute liver failure in a previously healthy female adolescent infected with SARS-CoV-2 with biopsy evidence of replicating virus in hepatocytes, which has not been previously reported. Keywords: COVID-19, acute liver failure, liver transplant

CITATION EXPORT

Babak John Orandi, Geling Li, Deepti Dhall et al.. Acute Liver Failure in a Healthy Young Female With COVID-19. JPGN Reports. (2021). https://doi.org/10.1097/PG9.0000000000000108

AUTHORS

14 · 7 CENTRES

Babak John Orandi, Geling Li, Deepti Dhall, Prachi Bajpai, Upender Manne, Nitin Arora, Ailing Lu, Ana Carolina Coronado, Rachel Kassel, Swetha Pinninti, Cora Elizabeth Lewis, Christopher Chapleau, Jayme Elizabeth Locke, Luz Helena Gutierrez Sanchez

From the *Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
†Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
‡Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
§Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
‖Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
¶Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
#Department of Pharmacy, University of Alabama, at Birmingham, Birmingham, AL.