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儿童不明原因急性重症肝炎综述:呼吁关注

A review on acute, severe hepatitis of unknown origin in children: A call for concern.

作者信息

Uwishema Olivier, Mahmoud Ashraf, Wellington Jack, Mohammed Suhaila Mamdouh, Yadav Tularam, Derbieh Mirna, Arab Sara, Kolawole Barakat

机构信息

Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.

Clinton Global Initiative University, New York, USA.

出版信息

Ann Med Surg (Lond). 2022 Aug 18;81:104457. doi: 10.1016/j.amsu.2022.104457. eCollection 2022 Sep.

Abstract

Hepatitis is defined as the inflammatory reaction of the liver parenchyma. It is either acute, which resolves within six months or may be chronic. An outbreak of severe, acute hepatitis of unknown origin in children was reported in nearly all World Health Organisation (WHO) regions except in the Africa. As per the recent update on the 26th of May, approximately 650 cases have met the WHO's probable criteria. While some are yet to be confirmed, the WHO warns that the figure may be underestimating the real situation. The observed clinical presentation includes outstanding immoderate levels of transaminases, vomiting from the previous presentation, pale/mild stools, and jaundice. So far, the viruses which can cause viral hepatitides, like Hepatitis A, B, C, D, and E, have not been detected in any of the identified cases. Some literature reported human enteric adenovirus type 41F in the majority of cases aged sixteen or younger, with few cases of co-infection with SARS-CoV-2. Currently, only several hypotheses have discussed the causality of the outbreak. However, no consensus has been reached. During this outbreak, it is important to adhere to both hand and body hygiene, general infection and control prevention strategies, and lastly, case presentation matching the criteria of case definition set by the WHO. Said identified cases should be reported to concerned health authorities on an urgent basis and must be kept under proper surveillance.

摘要

肝炎被定义为肝实质的炎症反应。它要么是急性的,在六个月内痊愈,要么可能是慢性的。除非洲外,几乎所有世界卫生组织(WHO)区域都报告了儿童中出现的不明原因的严重急性肝炎疫情。根据5月26日的最新消息,约650例病例符合WHO的可能标准。虽然一些病例尚未得到确认,但WHO警告称,这一数字可能低估了实际情况。观察到的临床表现包括转氨酶水平异常升高、先前出现呕吐、大便苍白/浅色以及黄疸。到目前为止,在任何确诊病例中均未检测到可导致病毒性肝炎的病毒,如甲型、乙型、丙型、丁型和戊型肝炎病毒。一些文献报道,在大多数16岁及以下的病例中检测到人类肠道腺病毒41F型,少数病例同时感染了SARS-CoV-2。目前,只有几种假说讨论了此次疫情的病因,但尚未达成共识。在此次疫情期间,坚持手部和身体卫生、一般感染和防控策略非常重要,最后,病例表现应符合WHO设定的病例定义标准。上述确诊病例应紧急报告给相关卫生当局,并必须进行适当监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6875/9486726/8bffd21ba5d5/gr1.jpg

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