A case of measles-associated hepatitis
https://doi.org/10.66825/2949-4664-apps-3-3-46-51
Abstract
In this article, we describe a clinical case of acute hepatitis associated with measles infection in a child. This was part of a series of cases registered in St. Petersburg during the measles outbreak of 2023–2024. The patient had a typical course of measles. The complications included dyspeptic disorders with predominant involvement of the upper gastrointestinal tract. Physical examination revealed the presence of hepatomegaly, with no other clinical signs of liver involvement observed. No signs of liver failure, such as impaired protein-synthetic function of the liver, coagulopathy, or hepatic encephalopathy were noted. Laboratory tests revealed a cytolysis syndrome with ALT and AST levels being 9–10‑fold higher than the upper limit, as well as moderate cholestasis. Over time, laboratory parameters normalized during the early convalescent period. Liver involvement is not a classical manifestation of measles; however, the literature presents cases up to the development of severe hepatitis requiring liver transplantation. The potential hepatotropic effect of the measles virus is evidenced by literature reports of its detection in hepatocytes based on histological studies. In this article, we demonstrate the possibility of hepatitis development in pediatric patients with measles.
Keywords
measles in children,
hepatitis in measles,
liver damage in measles,
cytolysis syndrome in measles,
unspecified hepatitis
Supporting agencies: No external funding was attracted.
About the Authors
E. A. Ulanova
Federal Research and Clinical Center for Infectious Diseases
Russian Federation
Competing Interests:
Russian Federation
Ekaterina A. Ulanova, Junior Researcher, Research Department of Viral Hepatitis and Liver Diseases
9 Pr. Popova St., Saint-Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest
V. A. Greshnyakova
Federal Research and Clinical Center for Infectious Diseases; Saint-Petersburg State Pediatric Medical University; Saint-Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Vera A. Greshnyakova, Cand. Sci. (Med.), Head of the Research Department of Viral Hepatitis and Liver Diseases; Associate Professor of the Department of Infectious Diseases in Children, Faculty of Postgraduate and Continuing Professional Education
9 Pr. Popova St., Saint-Petersburg, 197022; 2 Litovskaya St., Saint-Petersburg, 194100; 7–9 Universitetskaya Embank., Saint-Petersburg, 199034
Competing Interests:
The authors declare no conflict of interest
L. G. Goryacheva
Federal Research and Clinical Center for Infectious Diseases; Saint-Petersburg State Pediatric Medical University
Russian Federation
Competing Interests:
Russian Federation
Larisa G. Goryacheva, Dr. Sci. (Med.), Leading Researcher, Research Department of Viral Hepatitis and Liver Diseases; Prof., Department of Infectious Diseases in Children, Faculty of Postgraduate and Continuing Professional Education
9 Pr. Popova St., Saint-Petersburg, 197022; 2 Litovskaya St., Saint-Petersburg, 194100
Competing Interests:
The authors declare no conflict of interest
References
1. Berry T.J. Hepatic damage associated with measles. Pa Med J. 1960;63:995–9.
2. Lee K.Y., Lee H.S., Hur J.K. et al. Clinical features of measles according to age in a measles epidemic. Scand J Infect Dis. 2005;37(6–7):471–475. doi: 10.1080/00365540510037803.
3. Ben-Chetrit E., Oster Y., Jarjou’i A. et al. Measles-related hospitalizations and associated complications in Jerusalem, 2018–2019. Clin Microbiol Infect. 2020;26(5):637– 642. doi: 10.1016/j.cmi.2019.08.022.
4. Merino E., Ramos J.M., Reus S. et al. Measles in adults during an outbreak in Spain: hospitalization associated with gastrointestinal and liver involvement. Infection. 2014;42(4):763–765. doi: 10.1016/j.cmi.2019.08.022.
5. Golubovskaya O.A. Features of the clinical course of measles in adults during the 2018 epidemic. Klinicheskaya infektologiya i parazitologiya. 2018;4:518–526. (In Russ.).
6. Салдан И.П., Карбышева Н.В., Бобровский Е.А. и др. Клинико-эпидемиологическая характеристика кори у взрослых жителей Алтайского края. Журнал инфектологии. 2019;11(3):77–82. doi: 10.22625/2072-6732-2019-11-3-77-82[S1].
7. Cornelissen L., Grammens T., Leenen S. et al. High number of hospitalisations and non-classical presentations: lessons learned from a measles outbreak in 2017, Belgium. Epidemiol Infect. 2020;148:е35. doi: 10.1017/0950268820000278.
8. Saifullin M.A., Zvereva N.N., Nurmukhametova E.A. et al. Liver damage in measles.. Журнал инфектологии. [S2]2020;12(4):78–86. doi: 10.22625/2072-6732-2020-12-4-78-86.
9. Niculae C.M., Matoru R.M., Brinduse O. et al. High rates of hepatic involvement associated with new epidemic measles strains in Romania. J Med Virol. 2024;96(10):e70001. doi:10.1002/jmv.70001.
10. Isayev D., Ibrahimova G., Akhmedova S., Javadzade V. Clinical characteristics of measles in adults. Azerbaijan Medical Journal. 2024;1:56–61. (In Russ.). doi: 10.34921/amj.2024.1.009.
11. Birlutiu V., Birlutiu R.M. Measles-clinical and biological manifestations in adult patients, including a focus on the hepatic involvement: Results from a single-center observational cohort study from Romania. J Clin Med. 2024;13(18):е5535. doi: 10.3390/jcm13185535.
12. Ulanova E.A., Greshnyakova V.A. Features of liver damage in measles in children. Modern Pediatrics. St. Petersburg — White Nights — 2025: Collection of materials of the X Anniversary All-Russian Forum with International participation, St. Petersburg, June 20, 2025 — June 21, 2026. — St. Petersburg: St. Petersburg Regional branch of the public organization «Union of Pediatricians of Russia». 2025:123–125. EDN JTOMXN.
13. Ray G. Non hepatotropic virus induced hepatitis — rising importance in a changing world. World J Virol. 2025 Sep 25;14(3):107905. doi: 10.5501/wjv.v14.i3.107905.
14. Nobili V., Pietro S., Stefania P. Fulminant Hepatic Failure Following Measles. The Pediatric Infectious Disease Journal. 2007;26(8):766–767. doi: 10.1097/INF.0b013e3180cc2c4f.
15. Sati S.K., Banga S., Bhadouria S.S. Fulminant Hepatic Failure in Measles in a 6-Month-Old Child. Int J Clin Pediatr. 2018;7(1–2):17–18. doi: 10.14740/ijcp294w.
16. Ackerman Z., Flugelman M.Y., Wax Y. et al. Hepatitis during measles in young adults: possible role of antipyretic drugs. Hepatology. 1989.10(2):203–206.
17. Stahl J.P., Salmon D., Bruneel F. et al. Adult patients hospitalized for measles in France, in the 21st century. Med Mal Infect. 2013;43(10):410–416. doi: 10.1016/j.medmal.2013.07.001.
18. Satoh A., Kobayashi H., Yoshida T. et al. Clinicopathological study on liver dysfunction in measles. Intern Med. 1999;38(5):454–457.
Review
For citations:
Ulanova E.A., Greshnyakova V.A., Goryacheva L.G. A case of measles-associated hepatitis. Archives of Pediatrics and Pediatric Surgery. 2025;3(3):46-51. (In Russ.) https://doi.org/10.66825/2949-4664-apps-3-3-46-51
Views:
50
JATS XML
Email this article 