Case Report: Fatal Acute Liver Failure With Giant Cell Transformation in a Pediatric Patient Associated With MIS-C
Carolina Bonilla Gonzalez1, Marcela Hincapié Echeverría2, Rocio Plazas Pachón2
1Pediatric Intensive Care Unit, Department of Pediatrics, Fundación Santafe of Bogotá, Bogotá, Colombia.
Insights
This study reports the first pediatric case of a 10-month-old boy with pediatric multi-system inflammatory syndrome (MIS-C) who experienced acute liver failure with giant cell transformation, leading to a fatal outcome despite treatment.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Infectious Diseases
- Critical Care Medicine
Background:
- Multi-system inflammatory syndrome in children (MIS-C) is a rare but serious condition.
- Acute liver failure is an uncommon but severe complication of MIS-C.
- This case highlights the potential for severe hepatic involvement in pediatric MIS-C.
Observation:
- A 10-month-old boy presented with symptoms consistent with MIS-C.
- The patient developed fulminant acute liver failure.
- Diagnostic workup excluded other common causes of liver failure.
Findings:
- The liver failure was characterized by giant cell transformation.
- Despite standard treatment for liver failure, the patient had a fatal outcome.
- Autopsy confirmed giant cell transformation as a key pathological finding.
Implications:
- This case underscores the critical need for early recognition and management of MIS-C.
- Understanding the spectrum of MIS-C complications, including severe liver injury, is crucial.
- Further research is needed to elucidate the mechanisms of MIS-C-associated liver failure and improve patient outcomes.
Abstract:
Background: We describe the first pediatric case of a 10-month-old boy with MIS-C who developed fulminant acute liver failure with associated giant cell transformation and a fatal outcome, after ruling out other infectious, metabolic, genetic, and autoimmune causes of liver failure following the usual algorithms for approaching the etiology. Although the patient received the main treatment strategies for liver failure, he had a fatal outcome. A clinical autopsy was considered as part of the diagnostic approach, which showed evidence of giant cell transformation.
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