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Drug-induced liver injury in children

Amin, Mansi D., Harpavat, Sanjiv, Leung, Daniel H.·2015·Current Opinion in Pediatrics
DOI 10.1097/mop.0000000000000264
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Abstract

Purpose of review Drug-induced liver injury (DILI) is an underrecognized cause of pediatric liver disease, accounts for almost 20% of pediatric acute liver failure cases, and is a major reason for liver transplantation in the USA. This article reviews the pathogenesis of DILI, approach to diagnosis and management, and highlights recent pediatric DILI case series. Recent findings Select individuals have an increased propensity to develop DILI. Known genetic polymorphisms of enzymes and host factors play an important role in medication management and influence the clinical outcome in 20-25% of all drug therapies. Children are more likely to have mitochondrial dysfunction from drugs, increasing their susceptibility to severe liver injury or acute liver failure. Antibiotics and central nervous system agents account for the majority of pediatric DILI in the West, although herbals are becoming more common. Summary Clinical features of DILI vary and overlap so exclusion of other conditions, identification of latency period and risk factors, and use of a searchable database can aid evaluation. Treatment consists of cessation of the offending agent and supportive care. Areas needing further research include elucidating mechanisms, identifying at risk individuals, and therapeutic interventions.

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  • Scientifically valid information for pediatric prescriptions is scarce; adult information is often used because clinical trials in children are difficult to perform.

    “However, the scientifically valid information on which prescriptions for children are currently based is very scarce. In many cases, the information used is that available for the adult population, since clinical trials in children are difficult to perform [4,5].”

    From Metabolomic Analysis of Pediatric Patients with Idiosyncratic Drug-Induced Liver Injury According to the Updated RUCAM (2023) · cites this paper as [4]

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Metadata

Authors
Amin, M. D., Harpavat, S., & Leung, D. H.
Venue
Current Opinion in Pediatrics
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-10
Volume
27
Issue
5
Pages
625-633
ISSN
1040-8703
DOI
10.1097/mop.0000000000000264
Cited by
29
References
1
Language
en

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