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[Adenovirus-related acute liver failure treated with intravenous immunoglobulin]
Melisa Zavala-Rodríguez1, Marco Antonio Martínez-Triana1, María Del Rocío Hernández-Morales2
1Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, México.
Insights
Intravenous immunoglobulin (IVIG) can be an effective adjuvant therapy for acute liver failure in children caused by viral infections. This treatment helped resolve liver failure in a pediatric patient with adenovirus and SARS-CoV-2 infections.
Area of Science:
- Pediatric Hepatology
- Infectious Diseases
- Immunology
Background:
- Acute liver failure (ALF) in children is a critical condition impacting liver synthesis and detoxification functions.
- Viral infections are a significant etiological factor in pediatric ALF, often necessitating supportive care or liver transplantation.
- Investigating viral causes is crucial for managing pediatric ALF.
Observation:
- A 2-year-old girl presented with ALF, testing positive for Adenovirus 41 and SARS-CoV-2 IgG antibodies.
- Initial supportive treatment for ALF did not yield improvement.
- Intravenous immunoglobulin (IVIG) was administered as a subsequent therapeutic intervention.
Findings:
- The administration of IVIG led to the resolution of acute liver failure in the pediatric patient.
- This case highlights a potential therapeutic response to IVIG in severe pediatric hepatitis of infectious origin.
- The patient's co-infection with Adenovirus 41 and SARS-CoV-2 provides a specific etiological context.
Implications:
- Intravenous immunoglobulin may possess immunomodulatory properties beneficial in treating pediatric ALF of infectious etiology.
- IVIG can be considered as a potential adjuvant therapy in select cases of severe acute hepatitis in children.
- Further research into IVIG's role in pediatric ALF is warranted to elucidate its mechanisms and efficacy.
Background:
Acute liver failure in pediatric age is a serious multisystem disease, characterized by a failure of the synthesis and detoxification function of the liver. Among the etiologies, viral infection should be investigated. Treatment is supportive and some cases require liver transplantation.
Case Report:
A 2-year-old girl was admitted for acute liver failure. The PCR viral panel was positive for Adenovirus 41 and IgG antibodies to SARS-CoV-2 were also found. Supportive treatment was started without improvement, so intravenous immunoglobulin was administered, with resolution of the liver failure.
Conclusions:
Immunoglobulin has immunomodulatory mechanisms in children with severe acute hepatitis of infectious etiology, so in some cases, its administration can be considered as adjuvant therapy.
