Acute hepatitis and liver failure associated with influenza A infection in children
Acute hepatitis and liver failure associated with influenza A infection in children
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DOI：
10.1097/01.mpg.0000232332.00677.3d
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发表时间：
2006-10-01
影响因子：
2.9
通讯作者：
Sokol, Ronald J.
中科院分区：
文献类型：
--
作者：
Whitworth, John R.;Mack, Cara L.;Sokol, Ronald J.
甲型流感病毒是单链RNA病毒正粘病毒科的成员。甲型流感感染引起的肺外表现相对较少。甲型流感感染的严重胃肠道并发症很少见，包括胰腺炎、出血性胃炎和Reye综合征（1 Y3）。有报道称，患有基础慢性肝病的成人会出现急性肝代偿失调（4）。我们描述了4名以前健康的甲型流感感染儿童并发急性肝炎伴或不伴急性肝衰竭。3例经支持治疗后痊愈; 1例出现与潜在的丝裂软骨病一致的症状。这是第一次报告的严重肝炎或肝功能衰竭与甲型流感感染的健康儿童，并表明，甲型流感病毒可能是hepatropic.We审查了所有儿童的图表，提出了儿童医院急性肝炎或急性肝功能衰竭期间，科罗拉多甲型流感流行的2003年至2004年。我们确定了2例重型肝炎患者和2例与甲型流感感染相关的急性肝功能衰竭患者。肝功能衰竭定义为无已知肝病的患者出现急性肝功能障碍、脑病和凝血功能障碍（凝血酶原时间> 20秒）（5）。急性肝炎定义为肝脏炎症持续时间少于6个月，转氨酶升高2倍以上
Influenza A is a member of the orthomyxoviridae family of single-stranded RNA viruses. Infection with influenza A causes relatively few extrapulmonary manifestations. Severe gastrointestinal complications of influenza A infection are rare and include pancreatitis, hemorrhagic gastritis and Reye syndrome (1Y3). Acute hepatic decompensation in adults with underlying chronic liver disease has been reported (4). We describe 4 previously healthy children with influenza A infection who developed concurrent acute hepatitis with or without acute liver failure. Three recovered with supportive care; 1 developed symptoms consistent with an underlying mitochondropathy. This is the first report of severe hepatitis or liver failure associated with influenza A infection in healthy children and suggests that influenza A virus may be hepatotropic.We reviewed the charts of all children presenting to The Children’s Hospital with acute hepatitis or acute liver failure during the Colorado influenza A epidemic of 2003Y2004. We identified 2 patients with severe hepatitis and 2 with acute liver failure associated with influenza A infection. Liver failure was defined as acute liver dysfunction, encephalopathy and coagulopathy (prothrombin time,> 20 seconds) in a patient with no known liver disease (5). Acute hepatitis was defined as inflammation of the liver lasting less than 6 months, with a more than 2-fold elevation of aminotransferases