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U.K. health officials are investigating dozens of cases of unexplained hepatitis, or liver inflammation, that have recently emerged among young children there. Similar cases of pediatric hepatitis have also been reported in the U.S. and Spain.

Some of the affected children in the U.K. have required assessment at specialized centers and a “small number” of kids have undergone liver transplantation procedures, the U.K. Health Security Agency (UKHSA) announced on April 8. Although hepatitis viruses (hepatitis A, B, C, D and E) are often the cause of hepatitis, these viruses have been ruled out, the statement said. Potential complications of hepatitis include liver failure and death, and liver transplants are typically used to treat end-stage liver failure, according to Stanford Children’s Health.

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