Update on acute liver inflammation of unknown origin in children

Unexplained cases of acute liver inflammation in children, especially in the United Kingdom (U.K.), were reported earlier this year. In response, the European Reference Network on Hepatological Diseases (ERN RARE-LIVER) conducted a thorough investigation that did not confirm the alarming observation from the U.K. in other European countries. However, an infectious cause remains the main suspected culprit in this outbreak. Published in Eurosurveillance, the most recent data suggest a co-infection of adenovirus with an adeno-associated virus.

In the meantime, other surveillance tools have been installed as for example, by the European Center of Disease Control (ECDC; cdn.ecdc.europa.eu/novhep-surveillance) showing a clear decrease in reported cases since the end of April. To evaluate whether this reflects the situation in specialized centers across Europe, the ERN RARE-LIVER conducted a short follow-up survey in collaboration with the working group on acute liver failure. While the awareness of this condition remains high in the field, the decrease reflects the situation in all 23 expert centers across Europe that participated in the survey.

"This is relieving news. Nevertheless, it is essential to further monitor the numbers in the upcoming months," said Dr. Dominic Lenz from the Center for Pediatric and Adolescent Medicine at the Heidelberg University Hospital, and leader of the ERN RARE-LIVER working group for acute liver failure.

"This European Network provides an excellent framework to observe the further development, and to thus help to elucidate the causes of this condition, and to act quickly in case of a potential seasonal increase during the winter months," adds ERN RARE-LIVER Coordinator, Prof. Ansgar W. Lohse, Clinic Director of the I. Department of Medicine at the University Medical Center Hamburg-Eppendorf.

Therefore, the ERN RARE-LIVER is in touch with the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) as well as with other leading institutions in the field of Virology and Immunology to set up a state-of-the art approach to shed light on those cases.