Neonatal acute liver failure due to enteroviruses: a 14 years single NICU experience: Journal of Maternal-Fetal and Neonatal Medicine

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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 ALF in neonates. HEV testing should be systematically performed in cases of neonatal ALF for diagnostic and management purposes. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Original languageEnglish
Pages (from-to)2576-2580
Number of pages5
JournalJ. Matern.-Fetal Neonatal Med.
Issue number15
Publication statusPublished - 2020


  • Enterovirus
  • liver failure
  • neonatal hepatitis
  • neonate
  • viral hepatitis
  • ferritin
  • acute liver failure
  • Article
  • autopsy
  • bone marrow biopsy
  • brain edema
  • case report
  • clinical article
  • congestive heart failure
  • cytolysis
  • data base
  • disseminated intravascular clotting
  • Enterovirus infection
  • female
  • heart ventricle hypertrophy
  • hemochromatosis
  • hepatosplenomegaly
  • human
  • human tissue
  • hyperbilirubinemia
  • hypertrophic cardiomyopathy
  • infant
  • liver biopsy
  • liver function test
  • liver necrosis
  • male
  • medical record
  • metabolic acidosis
  • microscopy
  • neonatal intensive care unit
  • patient referral
  • peritoneal dialysis
  • priority journal
  • public health
  • real time polymerase chain reaction
  • salivary gland biopsy
  • virus transmission


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