Youngest liver transplant patient among cases being investigated for links to global liver illness

Global health officials are investigating nearly 200 cases of acute hepatitis around the world, including in the United States.  It’s unclear whether the cases are connected. The cause is unknown although some patients also tested positive for adenovirus.

A growing number of states are reporting cases of liver illness among children. The Minnesota Department of Health (MDH) confirmed to 5 EYEWITNESS NEWS that it’s investigating several cases of hepatitis of unknown origin among Minnesota children.

M Health Fairview said it reported two cases to MDH, including an infant.

Elsie Freeman was born last fall and received a liver transplant at just 4 weeks old. Her doctors believe she’s Minnesota’s youngest liver transplant patient.

She and her twin, Ethan, were born healthy at nearly full term in October. When Elsie was about 3 weeks old, she suddenly started showing symptoms of jaundice.

“All of a sudden, she started looking a little yellow, and then the next day it was darker, and then her eyes were changing color,” said her mother Stacie Haverkamp, during an interview in March. “She wasn’t jaundiced before, and so I was getting a little concerned.”

Haverkamp and James Freeman, Elsie’s parents, rushed her to urgent care and then to M Health Fairview Masonic Children’s Hospital. Tests showed her liver was failing.

Transplant surgeon Dr.  Srinath Chinnakotla told us in March, “With her severity of liver failure, if she didn’t get a liver transplant, her chance of surviving a week were pretty slim.”

The surgery was successful and now, months later, her doctors are still working to figure out what caused her liver to fail.

“Retrospectively, we still don’t know what caused it,” said Dr. Heli Bhatt, a pediatric gastroenterologist and transplant hepatologist who treated Elsie.

The Centers for Disease Control and Prevention (CDC) issued an alert on April 21, that asked doctors to look out for and report any suspected cases of hepatitis of unknown origin. Last week, Dr. Bhatt reported Elsie’s case to the Minnesota Department of Health.

“This being such a severe case of inflammation of liver, all of the cells broke down, her liver failed beyond the point of recovery without any reason per-se and also the fact that her twin had been healthy,” explained Dr. Bhatt. “It is still kind of in the same timeline, her age is so typical of this that I felt it was important to still readdress that.”

Dr. Bhatt said there’s no way to test Elsie for adenovirus now but MDH is reviewing samples collected throughout her treatment. She spoke to Elsie’s parents on Thursday.

“I couldn’t say anything definitely,” said Dr. Bhatt. “The only thing I could say is this reminds me of Elsie’s case. Can I say for sure that this is what Elsie had? I don’t know. Is there any way I can go back and test for it? I don’t think so.”

She added, “We hope that we’ll figure it out and find out. But I think the one good thing that we know is we had good supportive care, we did the transplant, she’s doing good and I think that’s the best outcome.”

Haverkamp told 5 EYEWITNESS NEWS on Monday, “It’s just crazy that she was one of the youngest [transplant patients] and now this. Her case just keeps being different.”

She reiterated they don’t know with 100% certainty that Elsie’s case is connected to the others. At this point, Haverkamp still considers Elsie’s case a mystery.

The possibility of a connection between so many children’s illnesses globally is scary, she said.

M Health Fairview is also currently treating a 2-year-old who also suffered severe liver illness and is now on the transplant list. According to Dr. Bhatt, that child has now tested positive for adenovirus.

Physicians are working to determine the correct course of treatment for the toddler.

“How can we prevent this kid from needing a transplant,” said Dr. Bhatt.