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Clinical Spectrum and Outcome of Pediatric Drug Induced Liver Injury

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Abstract

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).

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Contributions

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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Authors and Affiliations

  1. Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110070, India

    Aditi Kumar, Vikrant Sood, Rajeev Khanna, Sanjeev Kumar Verma, Nikhil Mehra, Dinesh Rawat & Seema Alam

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  1. Aditi Kumar
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  2. Vikrant Sood
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  3. Rajeev Khanna
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  4. Sanjeev Kumar Verma
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  5. Nikhil Mehra
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  6. Dinesh Rawat
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  7. Seema Alam
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Corresponding author

Correspondence to Seema Alam.

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Kumar, A., Sood, V., Khanna, R. et al. Clinical Spectrum and Outcome of Pediatric Drug Induced Liver Injury. Indian J Pediatr 85, 676–678 (2018). https://doi.org/10.1007/s12098-017-2570-3

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  • DOI: https://doi.org/10.1007/s12098-017-2570-3

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