Evidence map›Paper›PMID 39328418›Full record

Observational studyFrontiers in immunology2024

Increased incidence of seronegative autoimmune hepatitis in children during SARS-CoV-2 pandemia period.

Muriel Schmutz, Suzanne Chartier, Thierry Leblanc, Charlotte Mussini, Antoine Gardin, Emmanuel Gonzales, Anne-Marie Roque-Afonso, Solene Le Cam, Geraldine Hery, Benedicte Neven and 5 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. SteamedNutrients · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Muriel SchmutzPediatric Hepatology and Pediatric Liver Transplant Department, Reference Center for Biliary Atresia and Genetic Cholestasis, FSMR FILFOIE, European Reference Networks (ERN) RARE LIVER, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Suzanne ChartierPathology Department, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Thierry LeblancDepartment of Pediatric Hematology and Immunology, AP-HP, Université Paris Cité Paris, Robert Debré Hospital, Paris, France.
Charlotte MussiniPathology Department, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Antoine GardinPediatric Hepatology and Pediatric Liver Transplant Department, Reference Center for Biliary Atresia and Genetic Cholestasis, FSMR FILFOIE, European Reference Networks (ERN) RARE LIVER, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Emmanuel GonzalesPediatric Hepatology and Pediatric Liver Transplant Department, Reference Center for Biliary Atresia and Genetic Cholestasis, FSMR FILFOIE, European Reference Networks (ERN) RARE LIVER, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Anne-Marie Roque-AfonsoINSERM Unité Mixte de Recherche (UMR)-S 1193, Paris-Saclay University, Hépatinov, Orsay, France.
Solene Le CamPediatric Radiology Department, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Geraldine HeryDepartment of Paediatric Surgery, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Benedicte NevenPediatric Hematology-Immunology and Rheumatology Department, AP-HP, Université Paris Cité Paris, Necker-Children's Hospital, Paris, France.
Ramy CharbelPediatric Intensive Care Unit, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Jean-Pierre VartanianVirus and Cellular Stress Unit, Department of Virology, Institut Pasteur, Université de Paris Cité, Paris, France.
Emmanuel JacqueminPediatric Hepatology and Pediatric Liver Transplant Department, Reference Center for Biliary Atresia and Genetic Cholestasis, FSMR FILFOIE, European Reference Networks (ERN) RARE LIVER, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Guillaume MorelleCentre for Haemophilia and Constitutional Bleeding Disorders, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.
Marion AlmesPediatric Hepatology and Pediatric Liver Transplant Department, Reference Center for Biliary Atresia and Genetic Cholestasis, FSMR FILFOIE, European Reference Networks (ERN) RARE LIVER, AP-HP, Paris-Saclay University, Bicêtre Hospital, Kremlin-Bicêtre, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Seronegative autoimmune hepatitis in children is a rare but potentially severe disease, sometimes requiring liver transplantation. This type of hepatitis may be associated with various immunological and hematological disorders, ranging from isolated lymphopenia to aplastic anemia. Precise pathophysiological mechanisms are still unknown, but the role of viruses cannot be excluded, either as directly pathogenic or as triggers, responsible for an inappropriate immune stimulation. Having the impression of an increasing number of seronegative autoimmune hepatitis since the beginning of SARS-CoV-2 pandemia period, we hypothesized that SARS-CoV-2 virus could be an infectious trigger. Methods: We conducted a retrospective, observational, descriptive study about children with seronegative autoimmune hepatitis, in a tertiary care center, between 2010 and 2022. Results: Thirty-two patients were included. The overall incidence of seronegative autoimmune hepatitis increased 3.3-fold in 2020-2022, during the SARS-CoV-2 pandemia period (16 patients in 2.8 years) compared with 2010-2019 the pre pandemia period (16 patients in 9 years). Patients' clinical and biochemical liver characteristics did not differ between the two periods. Hematological damages were less severe during the pandemia period. Immunological studies revealed a dysregulated immune response. The initiation of immunosuppressive therapy (corticosteroids ± cyclosporine) was earlier during the pandemia period than before. Conclusion: In cases of undetermined acute hepatitis, an immune-mediated origin should be considered, prompting a liver biopsy. If the histological aspect points to an immune origin, immunosuppressive treatment should be instituted even though autoimmune hepatitis antibodies are negative. Close hematological monitoring must be performed in all cases. The 3.3-fold increase of cases during the SARS-CoV-2 pandemia will need to be further analyzed to better understand the underlying immunological mechanisms, and to prove its potential involvement.

Indexed as

COVID-19Hepatitis, AutoimmuneSARS-CoV-2AdolescentChildChild, PreschoolFemaleHumansImmunosuppressive AgentsIncidenceInfantMaleRetrospective StudiesImmunosuppressive Agentsaplastic anemiadysimmunityimmunosuppressive treatmentpediatric seronegative autoimmune hepatitissevere acute respiratory syndrome coronavirus 2

Identifiers

PMID39328418
PMCPMC11425678

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Registered trials

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