COVID‐19 presenting as severe acute hepatitis in a pediatric patient with thalassemia minor: A case report

Abstract

Key Clinical MessageThis case emphasizes the significance of COVID‐19 in pediatric patients presenting with unusual hepatic manifestations, urging clinicians to broaden their diagnostic lens. The unexpected elevation of SARS‐CoV‐2 antibodies and the effective use of N‐acetyl cysteine highlight the importance of adaptability in treatment strategies.AbstractThis case report presents a unique manifestation of severe hepatic involvement in a 4‐year‐old girl with thalassemia minor and COVID‐19. Despite the absence of prominent respiratory symptoms, the patient exhibited jaundice, elevated liver enzymes, and coagulopathy. Initial suspicion of viral hepatitis was replaced by the discovery of significantly elevated SARS‐CoV‐2 antibodies. A multidisciplinary approach, including gastroenterology consultation and an extensive workup, was pivotal in ruling out alternative etiologies. Unconventional use of N‐acetyl cysteine contributed to clinical improvement, highlighting the need for adaptable treatment strategies. This case underscores the importance of heightened awareness in recognizing atypical presentations of COVID‐19 in pediatric patients, especially those with underlying health conditions. Further exploration into nuanced manifestations and treatment approaches is warranted for comprehensive clinical management.