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,to check access.
Access this article
Similar content being viewed by others
Bucuvalas J, Yazigi N, Squires R. Acute liver failure in children. Clin Liver Dis. 2006; 10: 149–168.
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.
Ostapowicz J, Lee WM. Acute hepatic failure: a western perspective. J Gastroenterol Hepatol. 2000;15;480–488.
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.
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.
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.
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.
Tryambak S, Ganguly S. Etiology, clinical profile and prognostic indicators for children with acute liver failure. Trop Gastroenterol. 2007;28:135–139.
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.
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.
O’Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989;97:439–445.
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.
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