key: cord-0045185-byp9gg21
authors: Kumar, Vijay; Chakraborty, Soumalya; Gowtham, BC; Kumar, Surjeet; Angurana, Suresh Kumar; Muralidharan, Jayashree
title: H1N1 Infection Presenting as Acute Liver Failure in an Infant
date: 2020-06-11
journal: Indian J Pediatr
DOI: 10.1007/s12098-020-03386-w
sha: 4ce24f3135b2e5c8f5aad618cf2b80df3077b87e
doc_id: 45185
cord_uid: byp9gg21

nan

were added. He showed gradual improvement in clinical and biochemical parameters, was extubated on day 5, received oseltamivir for 7 d, and discharged on day 8, and had pre-morbid neurological status on 3 mo follow-up. H1N1 (Influenza A) is usually an acute and self-limited respiratory illness. The severe cases can present with pneumonia, acute respiratory distress syndrome, septic shock, neurological involvement, myocardial dysfunction, and multiorgan failure [1] . H1N1 with liver involvement is rarely reported in children and accounts for <3% of all H1N1 cases [2] [3] [4] [5] . The liver involvement in H1N1 is believed to be due to overproduction of pro-inflammatory cytokines leading to changes in hepatic metabolism and enzyme activity, increased hepatic oxidative stress, decreased antioxidant defences, and damage by viral antigens rather than the direct viral invasion [6] . Whitworth et al. reported 4 children (aged 14-39 mo) with influenza A presenting as acute hepatitis and who recovered with supportive therapy [3] . Li et al. reported 2 children with severe influenza A (H3N2) with hepatic dysfunction who were treated with supportive treatment, mechanical ventilation, high dose corticosteroids, and gamma globulin; and one child died [5] . To best of our knowledge, this is the first report of acute liver failure in a child with H1N1 infection from India.

Conflict of Interest None.

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