14-year-old girl undergoes liver transplant, doctors suspect severe hepatitis of unknown cause | Pernambuco

A 14-year-old girl from Ibimirim, in the Sertão of Pernambuco, underwent a liver transplant, this Friday (20), after the organ failed. According to the medical team at the Oswaldo Cruz University Hospital (Huoc), in Recife, the suspicion is that the problem was caused by hepatitis of unknown origin that has been affecting children (see video above).

On April 27, faced with the mysterious outbreak of hepatitis in children in Europe and the United States (USA), the Center for Strategic Information on Health Surveillance of Pernambuco (Cievs-PE) issued a warning note and oriented the entire health network , including public and private units, to notify the Ministry of Health.

In a press conference held this Friday at Huoc, doctors Américo Gusmão, digestive system surgeon, and Cláudio Lacerda, hepatologist, gave details about the patient’s case, whose name was not officially released.

Lacerda stated that the Ministry of Health “is already aware of this case” and “at this point it was also informed that she was transplanted”. The State Department of Health (SES-PE) reported that the case has already been reported.

THE g1 contacted the Ministry of Health to find out if the notification had been received, but did not get a response until the last update of this report.

Doctors Américo Gusmão and Cláudio Lacerda spoke this Friday (20th) about a liver transplant performed on a 14-year-old teenager, who, according to them, has suspected hepatitis of unknown origin — Photo: Everaldo Silva/TV Globo

Thus, the number of suspected cases of hepatitis in children with unknown causes in the state rose to six. Among the other five previous occurrences, one has been ruled out and four are under investigation.

When talking about the suspected case this Friday, Lacerda said that there was “a diagnosis of exclusion, made all over the world”. He explained that all tests were carried out and there was no identification of the reasons for the disease.

“Therefore, her diagnosis is hepatitis in its most unknown form, which is being called by the lay population, mainly, mysterious hepatitis”, said Lacerda.

The doctor recalled that among the symptoms of the disease are weakness, lack of appetite, jaundice and abdominal discomfort. In more severe cases, there may be mental confusion and drowsiness and even coma.

Doctors also said at the press conference that the patient has already arrived at the hospital in need of a liver transplant urgently due to an unknown hepatitis in Brazil. “It fills out the entire protocol for diagnosing this new form of acute hepatitis,” said Lacerda.

The doctor also said that the disease has two differentials: “predilection for babies and children and severity with a much higher frequency”.

He added that there are currently approximately 80 patients in Pernambuco awaiting a liver transplant. “This month, six transplants were performed at Huoc. two from yesterday [quinta] for today [sexta]”, he said.

Cláudio Lacerda informed that, in the United Kingdom, until last week, 17 transplants had been made because of the disease. In the United States there have also been transplants, he said.

Hospitalized just over a week ago, the girl was initially treated at the Arcoverde Regional Hospital, in the Sertão.

“The condition worsened and she was transferred to the Mestre Vitalino Hospital, in Caruaru. [no Agreste]. The staff understood that it was a case for a transplant and she was referred here”, said Cláudio Lacerda.

After the patient was placed in a national organ transplant system, a donor for the girl appeared in the state of Paraná. The donor was a 30-year-old man who was brain dead after suffering head trauma in a motorcycle accident.

“A team from Paraná left there at 2 am to capture this compatible liver for the girl from Pernambuco and put it on a FAB plane. [Força Aérea Brasileira]. The liver arrived here around 9 am”, explained Cláudio Lacerda.

According to the doctors, the surgery took approximately six hours and went well. In all, 18 health professionals participated and two rooms were working at the same time.

The team pointed out that the girl is expected to stay for about 15 days at the university hospital. According to doctors, she “is fine, admitted to the ICU, but stable”.

“It was a good liver, she received well, everything went well. It was her big break. She was getting worse and worse and if it took another 48 hours she might not be able to resist,” said Américo Gusmão.

Doctors who performed the transplant and Maria Lucineide, the patient’s mother, participated in a press conference in Recife — Photo: Everaldo Silva/TV Globo

Farmer Maria Lucineide da Conceição, 44, the girl’s mother, also participated in the interview. She said that when she got the news, she didn’t want to believe her daughter needed a transplant.

“I didn’t tell anyone, I expected to arrive in Recife and the doctor would find out that I didn’t need to. When the liver appeared, I was very grateful,” she declared.

Maria Lucineide added that she would like to thank the doctors. “I’ll be grateful for the rest of my life. Nothing has happened to me that was so hard and scary. I don’t know where I got such calm,” she said.

The first five suspected cases were analyzed by the government, four occurred in the interior of Pernambuco and one in Greater Recife.

The first was a 1-year-old boy, resident of Toritama, in Agreste, who was discharged. The second suspicious case report was from a 3-year-old girl, resident of Glória do Goitá, in Zona da Mata, still hospitalized.

On Tuesday (17), the state reported two more suspected cases in patients from Camaragibe, in Greater Recife, and from Casinhas, in Agreste.

In the case of Casinhas, a 9-year-old girl was admitted to the Oswaldo Cruz University Hospital (Huoc), in Recife, on Friday (13). She presented vomiting, jaundice, nausea and fatigue.

In the case of Camaragibe, an 11-year-old girl arrived at the Instituto de Medicina Integral Professor Fernando Figueira (Imip), in Recife, on Saturday (14), with abdominal pain, vomiting, jaundice, nausea and fatigue.

Also according to the SES, the two patients “continue to be hospitalized and are being monitored by multidisciplinary teams, carrying out the necessary tests for the investigation of the cases”.

The discarded case is that of a 14-year-old teenager who lives in Salgueiro, in the Sertão. He has been at the Oswaldo Cruz University Hospital (Huoc), in Recife, since May 10th.

SES-PE also said that “it continues to provide technical support to municipalities in carrying out complementary tests for laboratory analysis of viral hepatitis, agents possibly related to this type of hepatitis and other diseases”.

The government informed that it maintains contact with the entire health network and specialists in the area to monitor the occurrences.

The Health Department met with representatives of the Pernambuco Pediatric Society (Sopepe) to discuss the cases and define “assistance and surveillance flows”.

Hepatitis: what is it? See symptoms of mysterious hepatitis — Photo: Arte/g1

This Friday, the Ministry of Health reported that 73 cases of the disease were reported. Of these, 61 are under investigation and 12 have already been discarded. So far, no cases have been confirmed.

He also said that he set up a Situation Room to monitor and follow up on cases in Brazil. The initiative aims to support investigations, as well as the collection of evidence to identify possible causes.

The room has the participation of technicians from the Ministry of Health, the Pan American Health Organization (PAHO) and other specialists.

In addition to monitoring, the measure “will standardize information and guide the flows of notification and investigation of cases for all state and municipal health departments, as well as for the Central Laboratories”.

Second largest lethal infectious disease in the world, behind only tuberculosis, hepatitis is inflammation of the liver. As of Friday, cases were being investigated in 13 states.

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