{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:07:42Z","timestamp":1789052862145,"version":"build-2803163510"},"reference-count":8,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Dev Pathol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Acute liver failure in the neonate generates a broad differential diagnosis of varying etiology including inborn errors of metabolism, infections, cholestatic disorders, gestational alloimmune liver disease (GALD), alpha-1 antitrypsin deficiency, total parenteral nutrition-related injury, malignancy, and others. We present a case of a neonate born at 39\u2009weeks\u2019 gestational age who presented on day 5 of life with coxsackievirus (part of the enterovirus family) encephalitis and COVID-19 infection and was subsequently found to be in acute liver failure (INR 1.7 up to 2.8 [not correctable with parenteral vitamin K], ammonia 87\u2009umol\/L up to 142\u2009umol\/L, AST 1864\u2009IU\/L, ALT 535\u2009IU\/L) with increasing alpha-fetoprotein. Evaluation for possible liver transplantation included an abdominal MRI, which showed a 2.4\u2009\u00d7\u20091.7\u2009\u00d7\u20092.1\u2009cm round mass-like lesion in segment 2 of the liver, raising a differential diagnosis which included hepatoblastoma. This lesion and the background liver were biopsied. A nonspecific hepatitic pattern of injury was identified within the lesion and the background liver showed nodular post-necrotic changes with collapse of lobular architecture. While clinical case reports exist of acute hepatitis in neonates with COVID-19 alone and coxsackievirus alone, the role dual infection may play in causing severe liver injury is unique to our case and provides territory for continued investigation.<\/jats:p>","DOI":"10.1177\/10935266261427176","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:44:24Z","timestamp":1773985464000},"page":"561-565","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Regenerative Nodule as a Diagnostic Dilemma in the Neonate With Acute Liver Failure and a Focal Liver Lesion"],"prefix":"10.1177","volume":"29","author":[{"given":"Claire","family":"Castaneda","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9555-6428","authenticated-orcid":false,"given":"Jessica","family":"Gulliver","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katryn","family":"Furuya","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eumenia","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal","family":"Bockoven","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Wisconsin Hospital and Clinics, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarangarajan","family":"Ranganathan","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati Medical Center, Cincinnati Children\u2019s Hospital, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1179402"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1555806"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/10935266221122934"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/10935266251331191"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1309\/hcqwpwd50xhd2dw6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800436"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2007.06.006"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/labinvest.3700479"}],"container-title":["Pediatric and Developmental Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10935266261427176","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10935266261427176","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10935266261427176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:17:59Z","timestamp":1789049879000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10935266261427176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/10935266261427176"],"URL":"https:\/\/doi.org\/10.1177\/10935266261427176","relation":{},"ISSN":["1093-5266","1615-5742"],"issn-type":[{"value":"1093-5266","type":"print"},{"value":"1615-5742","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]}}}