Doctors Perplexed by 'Weird' Liver Ailment in Children

Theories are starting to emerge
By Newser Editors and Wire Services
Posted May 23, 2022 2:31 AM CDT
As Mysterious Liver Ailment in Kids Spreads, Doctors Perplexed
Kids are silhouetted against a pond at a park in Lenexa, Kan., on Saturday, Dec. 26, 2020.   (AP Photo/Charlie Riedel, File)

Health officials remain perplexed by mysterious cases of severe liver damage in hundreds of young children around the world, the AP reports. The best available evidence points to a fairly common stomach bug that isn't known to cause liver problems in otherwise healthy kids. That virus was detected in the the blood of stricken children but—oddly—it has not been found in their diseased livers. “There's a lot of things that don't make sense,” said Eric Kremer, a virus researcher at the Institute of Molecular Genetics of Montpellier, in France. As health officials in more than a dozen countries look into the mystery, they are asking:

  • Has there been some surge in the stomach bug—called adenovirus 41—that is causing more cases of a previously undetected problem?
  • Are children more susceptible due to pandemic-related lockdowns that sheltered them from the viruses kids usually experience?
  • Is there some mutated version of the adenovirus causing this? Or some other not-yet-identified germ, drug or toxin?
  • Is it some kind of haywire immune system reaction set off by a past COVID-19 infection and a later invasion by some other virus? In a piece earlier this month in the medical journal Lancet, a pediatric immunologist and a scientist suggested that a combination of lingering coronavirus and an adenovirus infection could trigger a liver-damaging immune system reaction.

The US Centers for Disease Control and Prevention and investigators around the globe are trying to sort out what's going on. The illnesses are considered rare. CDC officials last week said they are now looking into 180 possible cases across the US. Most of the children were hospitalized, at least 15 required liver transplants and six died. More than 20 other countries have reported hundreds more cases in total, though the largest numbers have been in the UK and US. Many cases added to the tally in the last few weeks were not recent illnesses but rather earlier ones that were re-evaluated. About 10% of the US cases occurred in May, per a CDC official. The rate seems to be relatively flat since the fall, he added. It's possible that doctors are merely discovering a phenomenon that's been going on for years, some scientists said.

The scope of the problem only started to become clear last month, though disease detectives say they have been working on the mystery for months. It's been maddeningly difficult to nail a cause down, experts say. Conventional causes of liver inflammation in otherwise healthy kids—the viruses known as hepatitis A, B, C, D and E—didn't show up in tests. What’s more, the children came from different places and there seemed to be no common exposures. Recent genetic analysis has turned up no evidence that a single new mutant version of adenovirus is to blame, said Dr. Umesh Parashar, chief of the CDC group focused on viral gut diseases. Adenovirus infections are not systematically tracked in the US, so it's not clear if there's been some recent surge in virus activity. In fact, adenoviruses are so common that researchers aren't sure what to make of their presence in these cases.

(More liver stories.)

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