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Adenovirus ascending cholangiohepatitis

Marie-Anne Bründler1, Norberto Rodriguez-Baez, Ron Jaffe

  • 1Department of Pathology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
|February 8, 2003
PubMed

Insights

Adenovirus infection can cause cholangiohepatitis in children, particularly those with liver transplants or HIV. This study details the first reported cases of adenovirus affecting the human biliary tree, likely via gastrointestinal spread.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Gastroenterology

Background:

  • Hepatitis in immunocompromised children warrants thorough investigation.
  • Adenovirus is a common pathogen, but its role in biliary disease is not well-established.

Observation:

  • Three children, including two liver transplant recipients and one with HIV, presented with hepatitis and elevated gamma-glutamyl transpeptidase.
  • Liver biopsies revealed cholangiohepatitis, with adenovirus identified as the causative agent.
  • Progressive loss of interlobular bile ducts and necrotizing cholangitis were observed in some patients.

Findings:

  • This study reports the first human cases of adenovirus infection of the biliary tree.
  • Adenoviral inclusions were found in the biliary epithelium, indicating direct infection.
  • All patients exhibited evidence of concurrent adenovirus gastrointestinal infection.

Implications:

  • Adenovirus cholangiohepatitis is a newly identified clinical entity.
  • Ascending infection from the gastrointestinal tract is hypothesized as the mode of transmission.
  • This finding may impact the management of hepatitis in at-risk pediatric populations.

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