Skip to main content

Etiology and prognostic factors of acute liver failure in children

Indian Pediatrics volume 50, pages 677–679 (2013)Cite this article

Abstract

Acute liver failure (ALF) is a life-threatening condition characterized by jaundice, encephalopathy and coagulopathy leading to multiorgan failure in a patient with no prior history of liver disease. Forty three consecutive patients of ALF admitted in Pediatric ICU were studied for etiology and prognostic factors. Etiology was established in 91% cases. Viral infections were the most common cause. Mortality rate was 44%. Increasing grade of encephalopathy, >7 days interval between the onset of prodromal symptoms and encephalopathy, blood glucose <45mg/dL, serum bilirubin > 10mg/dL and pH <7.35 or >7.45 on admission were found to be associated with increased risk of mortality.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Bucuvalas J, Yazigi N, Squires R. Acute liver failure in children. Clin Liver Dis. 2006; 10: 149–168.

    PubMed  Article  Google Scholar 

  2. Acharya SK, Dasarathy S, Kumar TL, Sushma S, Presanna U, Tandon A, et al. Fulminant hepatitis in a tropical population: clinical course, cause and early predictors of outcome. Hepatology 1996;23:1448–1455.

    PubMed  Article  CAS  Google Scholar 

  3. Ostapowicz J, Lee WM. Acute hepatic failure: a western perspective. J Gastroenterol Hepatol. 2000;15;480–488.

    PubMed  Article  CAS  Google Scholar 

  4. Dhiman RK, Seth AK, Jain S, Chawla YK, Dilawari JB. Prognostic evaluation of early indicators in fulminant hepatic failure by multivariate analysis. Dig Dis Sci. 1998;43:1311–1316.

    PubMed  Article  CAS  Google Scholar 

  5. Lee WS, McKiernan P, Kelly DA. Etiology, outcome and prognostic indicators of childhood fulminant hepatic failure in United Kingdom. J Pediatr Gastroenterol Nutr. 2005;40:575–581.

    PubMed  Article  Google Scholar 

  6. Ostapowicz G, Fontana RJ, Scheiodt FV, Larson A, Davern TJ, Han SH, et al. Results of a prospective study of acute liver failure at 17 tertiary care centers in United States. Ann Intern Med. 2002;137:947–954.

    PubMed  Article  Google Scholar 

  7. Poddar U, Thapa BR, Prasad A, Sharma AK, Singh K. Natural history and risk factors in fulminant hepatic failure. Arch Dis Child. 2002;87:54–56.

    PubMed  Article  CAS  Google Scholar 

  8. Tryambak S, Ganguly S. Etiology, clinical profile and prognostic indicators for children with acute liver failure. Trop Gastroenterol. 2007;28:135–139.

    Google Scholar 

  9. Srivastava KL, Mittal A, Klumar A, Gupta S, Gupta S, Natu SM, Kumar R, et al. Predictors of outcome in fulminant hepatic failure in children. Indian J Gasroenterol. 1998;17:43–45.

    CAS  Google Scholar 

  10. Squires RH, Schneider BL, Bucuvalas J, Alonso E, Sokol RJ, Narkewicz MR, et al. Acute liver failure in children. The first 348 patients in the pediatric acute liver study group. J Pediatr. 2006;148:652–658.

    PubMed  Article  Google Scholar 

  11. O’Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989;97:439–445.

    PubMed  Google Scholar 

  12. Tripodi A, Caldwell SH, Hoffman M, Trotter JF, Sanval AJ. The prothrombin time test as a measure of bleeding risk and prognosis in liver disease. Aliment Pharmacol Ther. 2007;26:141–148.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Pediatrics, Kalawati Saran Childrens’ Hospital, Lady Hardinge Medical College, New Delhi, India

    Sharandeep Kaur, Praveen Kumar, Virendra Kumar & Arun Kumar

  2. Institute of Liver and Biliary Sciences, Delhi, India

    Shiv Kumar

  3. Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India

    Praveen Kumar

Authors
  1. Sharandeep Kaur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Praveen Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Virendra Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shiv Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arun Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Praveen Kumar.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kaur, S., Kumar, P., Kumar, V. et al. Etiology and prognostic factors of acute liver failure in children. Indian Pediatr 50, 677–679 (2013). https://doi.org/10.1007/s13312-013-0189-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-013-0189-7

Key words

  • Fulminant liver failure
  • Hepatic encephalopathy
  • Outcome
  • India