A NEW clinical framework for the investigation, monitoring, transfer and management of children with novel non-A-E acute hepatitis has been published by the Royal College of Paediatrics and Child Health.
The UK has seen an unusually high number of acute hepatitis cases in children in recent weeks and the UK Health Security Agency (UKHSA) has been working with the NHS and public health agencies across the UK to investigate potential causes.
Around 197 cases have been reported in the UK, with some transferred to specialist children’s liver units and a small number having undergone liver transplantation.
Guidance published by UKHSA in April this year recommended that clinicians be alert to children presenting with signs and symptoms of potential hepatitis, including jaundice and vomiting with other symptoms such as pruritus, arthralgia/myalgia, pyrexia and lethargy and/or loss of appetite.
No direct cause has yet been identified but there is evidence of a possible link between adenovirus infections and the increase of acute hepatitis cases.
The RCPCH points out that its new guidance provides general principles of care for this condition but each case should be treated in an “individual and nuanced way”.
It states: “Furthermore, the recommendations within the guidance are based on existing principles of management of acute hepatitis and acute liver failure and on expert consensus opinion in the absence of high quality evidence around this novel condition.”