Evidence map›Paper›PMID 35830627›Full record

ReviewThe New England journal of medicine2022

Clinical Spectrum of Children with Acute Hepatitis of Unknown Cause.

Chayarani Kelgeri, Michael Couper, Girish L Gupte, Alexandra Brant, Mitul Patel, Lauren Johansen, Joseph Valamparampil, Evelyn Ong, Hermien Hartog, M T P R Perera and 4 more

Open access · bronzeAbstract readReview
PubMed Publisher
In one paragraph

Review in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 2 pooled it
15.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 115 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  5. Article
  6. Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Investigation of an outbreak of novel hepatitis of unknown aetiology in children and adolescents, Ireland, 2021 to 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
  14. Observational
  15. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Chayarani KelgeriFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.ORCID 0000-0002-0112-2945
Michael CouperFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Girish L GupteFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Alexandra BrantFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Mitul PatelFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Lauren JohansenFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Joseph ValamparampilFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Evelyn OngFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Hermien HartogFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
M T P R PereraFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Darius MirzaFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Indra van MourikFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Khalid SharifFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
Jane HartleyFrom the Liver Unit, Birmingham Women's and Children's NHS Foundation Trust (C.K., M.C., G.L.G., A.B., L.J., J.V., E.O., H.H., M.T.P.R.P., D.M., I.V.M., K.S., J.H., M.P.), the Centre for Liver and Gastrointestinal Research, University of Birmingham (D.M.), and the Liver Unit, Queen Elizabeth Hospital (H.H., M.T.P.R.P., D.M.) - all in Birmingham, United Kingdom.
University Hospitals Birmingham NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince January 2022, there has been an increase in reports of cases of acute hepatitis of unknown cause in children. Although cases have been reported across multiple continents, most have been reported in the United Kingdom. Investigations are ongoing to identify the causative agent or agents.

methodsWe conducted a retrospective study involving children referred to a single pediatric liver-transplantation center in the United Kingdom between January 1 and April 11, 2022. These children were 10 years of age or younger and had hepatitis that met the case definition of the U.K. Health Security Agency for confirmed acute hepatitis that was not hepatitis A through E and did not have a metabolic, inherited or genetic, congenital, or mechanical cause, in the context of a serum aminotransferase level greater than 500 IU per liter. We reviewed medical records and documented demographic characteristics, clinical features, and results of liver biochemical, serologic, and molecular tests for hepatotropic and other viruses, as well as radiologic and clinical outcomes. The outcomes were classified as an improving condition, liver transplantation, or death.

resultsA total of 44 children had hepatitis that met the confirmed case definition, and most were previously healthy. The median age was 4 years (range, 1 to 7). Common presenting features were jaundice (in 93% of the children), vomiting (in 54%), and diarrhea (in 32%). Among the 30 patients who underwent molecular testing for human adenovirus, 27 (90%) were positive. Fulminant liver failure developed in 6 patients (14%), all of whom received a liver transplant. None of the patients died. All the children, including the 6 who received liver transplants, were discharged home.

conclusionsIn this series involving 44 young children with acute hepatitis of uncertain cause, human adenovirus was isolated in most of the children, but its role in the pathogenesis of this illness has not been established.

Indexed as

HepatitisLiver Failure, AcuteLiver TransplantationAcute DiseaseChildChild, PreschoolHumansInfantRetrospective Studies

Identifiers

PMID35830627
OpenAlexW4285395390

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.