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Pediatría Atención Primaria
Print version ISSN 1139-7632
Abstract
MIRO-VICEDO, Carla; RUIPEREZ-CEBRIAN, Concepción and GONZALEZ-DE DIOS, Javier. COVID-19 as a cause of acute hepatitis. Rev Pediatr Aten Primaria [online]. 2022, vol.24, n.96, pp.417-419. Epub Mar 04, 2024. ISSN 1139-7632.
Abstract
In the pathogenesis of acute liver damage related to SARS-CoV-2 infection, several hypotheses have been made: hepatotoxicity of drugs in the treatment of COVID-19; cytokine storm triggered by the immune hyperactivation; liver damage secondary to a situation of shock and hypoperfusion; and direct cytopathic effect of the virus.
We repot the case of a previously healthy 10-year-old boy who, in December 2020, developed acute hepatitis with a cytolytic pattern (ALT 1823 U/L and AST 1092 U/L), without associated increase in other cholestatic parameters, and who after the study, it could only be attributed to COVID-19, since he did not receive drugs that could damage the liver, nor did he present hemodynamic instability or involvement of other organs or multi-inflammatory disease. The diagnosis was made after exclusion of other microbiological causes and thanks to the detection of the virus both in the respiratory tract and in feces. A discussion is made about the possible direct cytotoxic effect of the virus and the current literature that supports this hypothesis, as well as the practicality of PCR detection of SARS-CoV-2 in feces for the diagnosis of COVID-19 with gastrointestinal involvement or liver-predominant involvement.
Keywords : COVID-19; Hepatitis; SARS-CoV-2.