A case of an Infant with SARS-CoV-2 hepatitis early after liver transplantation.
Biliary Atresia
/ complications
COVID-19
/ diagnosis
COVID-19 Testing
Female
Graft Rejection
Humans
Hydroxychloroquine
/ therapeutic use
Immunoglobulins, Intravenous
Immunosuppressive Agents
/ administration & dosage
Infant
Liver Failure
/ etiology
Liver Function Tests
Liver Transplantation
Living Donors
SARS-CoV-2
Hepatitis
SARS-CoV-2
SARS-CoV-2 hepatitis
acute rejection
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
29
04
2020
revised:
15
05
2020
accepted:
05
06
2020
pubmed:
20
6
2020
medline:
18
12
2020
entrez:
20
6
2020
Statut:
ppublish
Résumé
We present a case of a pediatric liver transplant recipient diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection four days after receiving a living donor liver allograft from her mother. The recipient was a 6-month-old with end-stage liver disease due to biliary atresia and failed Kasai. The infant had an uncomplicated implantation, excellent graft function and down-trending liver enzymes until developing fevers, diarrhea, and moderate respiratory distress requiring non-invasive respiratory support. SARS-CoV-2 testing (nasal swab Polymerase Chain Reaction) was positive on post-operative day (POD) 4. Liver enzymes peaked ~1000 U/L (5-fold higher than the previous day) on POD 6. Histology demonstrated a mixed picture of moderate acute hepatitis and classical elements of mild to moderate acute cellular rejection. Her hepatitis and respiratory symptoms improved coincident with completing treatment with hydroxychloroquine, reduced immunosuppression, and intravenous gamma globulin (IVIG).
Identifiants
pubmed: 32559354
doi: 10.1111/petr.13778
pmc: PMC7323125
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
Immunosuppressive Agents
0
Hydroxychloroquine
4QWG6N8QKH
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13778Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
J Clin Invest. 2020 Jun 1;130(6):2757-2765
pubmed: 32254064
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Liver Int. 2020 May;40(5):998-1004
pubmed: 32170806
Arch Pathol Lab Med. 2020 Apr 17;:
pubmed: 32302212
PLoS One. 2020 Mar 12;15(3):e0230183
pubmed: 32163484
Am J Transplant. 2020 Jul;20(7):1800-1808
pubmed: 32330343
Pediatr Transplant. 2020 Dec;24(8):e13778
pubmed: 32559354
J Infect Chemother. 2016 Apr;22(4):240-7
pubmed: 26867796
N Engl J Med. 2020 Apr 23;382(17):1663-1665
pubmed: 32187458
Liver Transpl. 2020 Jun;26(6):832-834
pubmed: 32196933