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,
to check access.Similar content being viewed by others
References
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.
Author information
Authors and Affiliations
Corresponding author
Rights 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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-013-0189-7