Neonatal acute liver failure due to enteroviruses: a 14 years single NICU experience

Iliana Bersani, Cinzia Auriti, Fiammetta Piersigilli, Andrea Dotta, Francesca Diomedi-Camassei, Alessandra Di Pede, Gabriele Buttinelli, Olivier Danhaive

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Neonatal acute liver failure (ALF) is a severe condition with a mortality rate up to 70%. Human enterovirus (HEV) infections are associated with serious diseases in newborns, including myocarditis, meningoencephalitis and, more rarely, ALF with a fulminant course.

METHODS: Cases of neonatal-onset ALF were identified using the institutional clinical database. The history and clinical data of infants with HEV infection were collected by medical record revision. Viral testing by nested real- time PCR (nRT-PCR) was performed by the Bambino Gesù Children's Hospital Clinical Laboratory and by National Institute of Public Health in Rome.

RESULTS: Among ten infants referred to our Institution with neonatal-onset ALF in the 2004-2018 period, we identified five cases due to HEV. In three of these, the mother reported an episode of mild fever and diarrhea during the last trimester of gestation, suggesting fetal-maternal transmission. All were late preterm infants (32-36 weeks). Two infants died as a result of ALF; the other three survived with full normalization of liver function. In four, the causing agents were coxsackie B serotypes 3 (n = 1), 4 (n = 1) and 5 (n = 2), in the fifth case we identified echovirus serotype 11.

CONCLUSIONS: Human enterovirus (HEV) are a rare but relevant cause of acute liver failure (ALF) in neonates. HEV testing should be systematically performed in cases of neonatal ALF for diagnostic and management purposes.

Original languageEnglish
Pages (from-to)1-171
JournalJournal of Maternal-Fetal and Neonatal Medicine
DOIs
Publication statusE-pub ahead of print - Dec 4 2018

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Acute Liver Failure
Enterovirus
Enterovirus Infections
Mothers
Newborn Infant
Human Enterovirus B
Hospital Laboratories
Meningoencephalitis
Myocarditis
National Institutes of Health (U.S.)
Third Pregnancy Trimester
Premature Infants
Medical Records
Real-Time Polymerase Chain Reaction
Diarrhea
Fever
Public Health
History
Databases
Pregnancy

Cite this

@article{2457b24722f943489824972b80feb518,
title = "Neonatal acute liver failure due to enteroviruses: a 14 years single NICU experience",
abstract = "BACKGROUND: Neonatal acute liver failure (ALF) is a severe condition with a mortality rate up to 70{\%}. Human enterovirus (HEV) infections are associated with serious diseases in newborns, including myocarditis, meningoencephalitis and, more rarely, ALF with a fulminant course.METHODS: Cases of neonatal-onset ALF were identified using the institutional clinical database. The history and clinical data of infants with HEV infection were collected by medical record revision. Viral testing by nested real- time PCR (nRT-PCR) was performed by the Bambino Ges{\`u} Children's Hospital Clinical Laboratory and by National Institute of Public Health in Rome.RESULTS: Among ten infants referred to our Institution with neonatal-onset ALF in the 2004-2018 period, we identified five cases due to HEV. In three of these, the mother reported an episode of mild fever and diarrhea during the last trimester of gestation, suggesting fetal-maternal transmission. All were late preterm infants (32-36 weeks). Two infants died as a result of ALF; the other three survived with full normalization of liver function. In four, the causing agents were coxsackie B serotypes 3 (n = 1), 4 (n = 1) and 5 (n = 2), in the fifth case we identified echovirus serotype 11.CONCLUSIONS: Human enterovirus (HEV) are a rare but relevant cause of acute liver failure (ALF) in neonates. HEV testing should be systematically performed in cases of neonatal ALF for diagnostic and management purposes.",
author = "Iliana Bersani and Cinzia Auriti and Fiammetta Piersigilli and Andrea Dotta and Francesca Diomedi-Camassei and {Di Pede}, Alessandra and Gabriele Buttinelli and Olivier Danhaive",
year = "2018",
month = "12",
day = "4",
doi = "10.1080/14767058.2018.1555806",
language = "English",
pages = "1--171",
journal = "Journal of Maternal-Fetal and Neonatal Medicine",
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}

TY - JOUR

T1 - Neonatal acute liver failure due to enteroviruses

T2 - a 14 years single NICU experience

AU - Bersani, Iliana

AU - Auriti, Cinzia

AU - Piersigilli, Fiammetta

AU - Dotta, Andrea

AU - Diomedi-Camassei, Francesca

AU - Di Pede, Alessandra

AU - Buttinelli, Gabriele

AU - Danhaive, Olivier

PY - 2018/12/4

Y1 - 2018/12/4

N2 - BACKGROUND: Neonatal acute liver failure (ALF) is a severe condition with a mortality rate up to 70%. Human enterovirus (HEV) infections are associated with serious diseases in newborns, including myocarditis, meningoencephalitis and, more rarely, ALF with a fulminant course.METHODS: Cases of neonatal-onset ALF were identified using the institutional clinical database. The history and clinical data of infants with HEV infection were collected by medical record revision. Viral testing by nested real- time PCR (nRT-PCR) was performed by the Bambino Gesù Children's Hospital Clinical Laboratory and by National Institute of Public Health in Rome.RESULTS: Among ten infants referred to our Institution with neonatal-onset ALF in the 2004-2018 period, we identified five cases due to HEV. In three of these, the mother reported an episode of mild fever and diarrhea during the last trimester of gestation, suggesting fetal-maternal transmission. All were late preterm infants (32-36 weeks). Two infants died as a result of ALF; the other three survived with full normalization of liver function. In four, the causing agents were coxsackie B serotypes 3 (n = 1), 4 (n = 1) and 5 (n = 2), in the fifth case we identified echovirus serotype 11.CONCLUSIONS: Human enterovirus (HEV) are a rare but relevant cause of acute liver failure (ALF) in neonates. HEV testing should be systematically performed in cases of neonatal ALF for diagnostic and management purposes.

AB - BACKGROUND: Neonatal acute liver failure (ALF) is a severe condition with a mortality rate up to 70%. Human enterovirus (HEV) infections are associated with serious diseases in newborns, including myocarditis, meningoencephalitis and, more rarely, ALF with a fulminant course.METHODS: Cases of neonatal-onset ALF were identified using the institutional clinical database. The history and clinical data of infants with HEV infection were collected by medical record revision. Viral testing by nested real- time PCR (nRT-PCR) was performed by the Bambino Gesù Children's Hospital Clinical Laboratory and by National Institute of Public Health in Rome.RESULTS: Among ten infants referred to our Institution with neonatal-onset ALF in the 2004-2018 period, we identified five cases due to HEV. In three of these, the mother reported an episode of mild fever and diarrhea during the last trimester of gestation, suggesting fetal-maternal transmission. All were late preterm infants (32-36 weeks). Two infants died as a result of ALF; the other three survived with full normalization of liver function. In four, the causing agents were coxsackie B serotypes 3 (n = 1), 4 (n = 1) and 5 (n = 2), in the fifth case we identified echovirus serotype 11.CONCLUSIONS: Human enterovirus (HEV) are a rare but relevant cause of acute liver failure (ALF) in neonates. HEV testing should be systematically performed in cases of neonatal ALF for diagnostic and management purposes.

U2 - 10.1080/14767058.2018.1555806

DO - 10.1080/14767058.2018.1555806

M3 - Article

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JO - Journal of Maternal-Fetal and Neonatal Medicine

JF - Journal of Maternal-Fetal and Neonatal Medicine

SN - 1476-7058

ER -