Clinical Spectrum and Outcome of Pediatric Drug Induced Liver Injury
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Limited literature is available in pediatric population regarding drug-induced liver injury (DILI) making it a diagnostic challenge. This study was thus planned to determine the clinical spectrum and the outcome of DILI in children. All patients with DILI under 18 y of age were retrospectively reviewed and details regarding clinical presentation, Roussel Uclaf Causality Assessment Method (RUCAM) scale, drugs implicated, biochemical abnormalities and outcome were noted. DILI constituted 3.7% of all children with liver disease. Cases were divided into the hepatocellular (18, 50%), cholestatic (10, 27.8%), and mixed pattern (8, 22.2%). Complementary and alternative medicines (CAM) and antitubercular (ATT) drugs accounted for three-fourth cases of total DILI (39% and 33% cases respectively). Overall, 4 (11%) patients died and 5 (14%) patients progressed to chronic DILI. Presence of ascites, non-hepatocellular injury pattern and high serum total IgG levels were significantly associated with unfavourable outcome (death or chronicity).
KeywordsPediatric drug induced liver injury Roussel Uclaf Causality Assessment Method (RUCAM) scale Complementary and alternative medicines
AK, VS, SKV and NM: Conceptualisation and design of study, acquisition, analysis and review of data, preparation of first draft; RK, SA and DR: Conceptualisation and design of study, critical review, statistical guidance, revision and approval of the final version. SA will act as guarantor for the paper.
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