Severe pancreatitis and fatty liver progressing to cirrhosis associated with Coxsackie B4 infection in a three year old with alpha-1-antitrypsin deficiency.

A 3-year-old girl in whom severe acute pancreatitis was associated with evidence of Coxsackie B4 virus infection was alpha-1-antitrypsin deficient. Lack of this modulator of proteolysis may have been responsible for her severe course. Fatty liver at presentation progressed to cirrhosis in the ensuing 18 months.