Adenovirus Hepatitis in Immunocompetent Adults

Area of Science:

• Hepatology
• Virology
• Internal Medicine

Background:

• Elevated liver function tests (LFTs) in adults necessitate a comprehensive differential diagnosis.
• Common causes include viral hepatitis, autoimmune diseases, and drug-induced liver injury.
• Adenovirus is a known pathogen but rarely implicated in hepatitis in immunocompetent adults.

Observation:

• A 35-year-old immunocompetent female presented with fever and elevated LFTs (AP, AST, ALT).
• Extensive workup excluded common viral hepatitis, autoimmune conditions, and drug-induced liver injury.
• A positive respiratory viral panel for adenovirus was noted.

Findings:

• The patient's symptoms and LFTs improved with supportive care, obviating the need for liver biopsy.
• This represents a potential case of adenovirus hepatitis in an immunocompetent adult.
• The RUCAM score suggested drug-induced injury was unlikely.

Implications:

• Clinicians should broaden the differential diagnosis for elevated LFTs to include adenovirus, especially in immunocompetent individuals.
• This case underscores the potential for adenovirus to cause hepatitis beyond its typical pediatric manifestations.
• Further research is warranted to understand the prevalence and clinical spectrum of adenovirus hepatitis in adults.