{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:01:23Z","timestamp":1778655683301,"version":"3.51.4"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:p>As of June 15, 2022, the Centers for Disease Control and Prevention has reported 296 pediatric patients under investigation for hepatitis of unknown etiology in the United States; the World Health Organization has reported 650 probable cases worldwide. One of the leading hypotheses for this cluster of cases is adenovirus, a virus that commonly causes respiratory or gastrointestinal symptoms in healthy children but rarely causes severe hepatitis or acute liver failure in immunocompetent children. The other leading hypothesis is that prior infection with SARS-CoV-2 may predispose children to developing liver injury from a normally innocuous agent. We describe a case of a previously healthy child presenting with acute liver failure who had detectable adenovirus DNA in his stool, whole blood, and in liver explant tissue, suggesting adenovirus as the likely etiology for the liver failure. He had no evidence of prior or current SARS-CoV-2 infection, nor had he received COVID vaccination, suggesting that SARS-CoV-2 did not play a role. Additionally, we report on the ability to provide rapid evaluation of a living donor within 72 hours and successfully perform a lifesaving, left-lobe, living donor liver transplant.<\/jats:p>","DOI":"10.1542\/peds.2022-059237","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T08:14:11Z","timestamp":1674548051000},"source":"Crossref","is-referenced-by-count":4,"title":["Acute Liver Failure in a Child With Adenovirus Detected by PCR in the Explanted Liver"],"prefix":"10.1542","volume":"151","author":[{"given":"Julia M.","family":"Boster","sequence":"first","affiliation":[{"name":"aDepartment of Pediatrics, Pediatric Liver Center, Digestive Health Institute and Section of Pediatric Gastroenterology, Hepatology & Nutrition"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel R.","family":"Dominguez","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics, Section of Pediatric Infectious Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Messacar","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics, Section of Pediatric Infectious Diseases"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Adams","sequence":"additional","affiliation":[{"name":"cDivision of Transplant Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus and Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Weinberg","sequence":"additional","affiliation":[{"name":"dDepartments of Pediatrics, Medicine and Pathology, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer O.","family":"Black","sequence":"additional","affiliation":[{"name":"eDepartment of Pathology and Laboratory Medicine, Children\u2019s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy G.","family":"Feldman","sequence":"additional","affiliation":[{"name":"aDepartment of Pediatrics, Pediatric Liver Center, Digestive Health Institute and Section of Pediatric Gastroenterology, Hepatology & Nutrition"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2023,1,24]]},"reference":[{"key":"2023111013552814800_B1","unstructured":"World Health Organization\n          . Disease outbreak news; acute hepatitis of unknown aetiology - the United Kingdom of Great Britain and Northern Ireland. Available at: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/acute-hepatitis-of-unknown- aetiology---the-united-kingdom-of- great-britain-and-northern-ireland. Accessed June 12, 2022"},{"key":"2023111013552814800_B2","unstructured":"World Health Organization\n          . Acute hepatitis of unknown aetiology in children - multi-country. Available at: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/ item\/DON-389. Accessed June 12, 2022"},{"issue":"7","key":"2023111013552814800_B3","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1056\/NEJMe2208409","article-title":"Acute hepatitis in children in 2022 - human adenovirus 41?","volume":"387","author":"Karpen","year":"2022","journal-title":"N Engl J Med"},{"key":"2023111013552814800_B4","unstructured":"Lucey\n              DR\n            \n          . Updates on severe hepatitis of unknown etiology. Available at: https:\/\/www.idsociety.org\/science-speaks-blog\/2022\/updates-on-severe-hepatitis-of-unknown-etiology\/#\/+\/0\/publishedDate_na_dt\/desc\/. Accessed June 12, 2022"},{"key":"2023111013552814800_B5","unstructured":"Cates\n              J\n            \n          . Interim analysis of acute hepatitis of unknown etiology in children aged &lt;10 years\u2013United States, October 2021-June 2022. Available at: https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/wr\/mm7126e1.htm. Accessed June 25, 2022"},{"issue":"7","key":"2023111013552814800_B6","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1056\/NEJMoa2206294","article-title":"A case series of children with acute hepatitis and human adenovirus infection","volume":"387","author":"Gutierrez Sanchez","year":"2022","journal-title":"N Engl J Med"},{"issue":"7","key":"2023111013552814800_B7","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1056\/NEJMoa2206704","article-title":"Clinical Spectrum of Children with Acute Hepatitis of Unknown Cause","volume":"387","author":"Kelgeri","year":"2022","journal-title":"N Engl J Med"},{"key":"2023111013552814800_B8","unstructured":"UK Health Security Agency\n          . Investigation into acute hepatitis of unknown aetiology in children in England: technical briefing 2. Available at: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/ 1073704\/acute-hepatitis-technical- briefing-2.pdf. Accessed June 25, 2022"},{"key":"2023111013552814800_B9","doi-asserted-by":"crossref","first-page":"150","DOI":"10.12688\/gatesopenres.13373.2","article-title":"T-cell responses to SARS-CoV-2 in unexposed South African women","volume":"5","author":"Nunes","year":"2022","journal-title":"Gates Open Res"},{"key":"2023111013552814800_B10","unstructured":"UK Health Security Agency\n          . Investigation into acute hepatitis of unknown aetiology in children in England: technical briefing 4. Available at: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/ 1094573\/acute-hepatitis-technical- briefing-4.pdf. Accessed September 15, 2022"},{"issue":"7","key":"2023111013552814800_B11","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/S2468-1253(22)00166-2","article-title":"Severe acute hepatitis in children: investigate SARS-CoV-2 superantigens","volume":"7","author":"Brodin","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"2","key":"2023111013552814800_B12","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.immuni.2022.01.014","article-title":"SARS-CoV-2 infections in children: understanding diverse outcomes","volume":"55","author":"Brodin","year":"2022","journal-title":"Immunity"},{"key":"2023111013552814800_B13","unstructured":"Organ Procurement & Transplantation Network\n          . Questions and answers about liver allocation. Available at: https:\/\/optn.transplant.hrsa.gov\/patients\/by-organ\/liver\/questions-and-answers-about-liver- allocation\/. Accessed June 12, 2022"},{"key":"2023111013552814800_B14","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/ajt.16978","article-title":"OPTN\/SRTR 2020 annual data report: liver","volume":"22","author":"Kwong","year":"2022","journal-title":"Am J Transplant"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2022-059237\/1564781\/peds_2022059237.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2022-059237\/1564781\/peds_2022059237.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T13:56:53Z","timestamp":1699624613000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/151\/2\/e2022059237\/190504\/Acute-Liver-Failure-in-a-Child-With-Adenovirus"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,24]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1,24]]},"published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2022-059237","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,24]]},"article-number":"e2022059237"}}