Abstract:
BACKGROUND/AIMS:Drug-induced liver injury (DILI) is a frequent cause of pediatric liver disease; however, the data on DILI are remarkably limited. METHODS:All 69 children hospitalized with DILI between January 2009 and December 2011 were retrospectively studied. RESULTS:A total of 37.7% of the children had medical histories of respiratory infection. The clinical injury patterns were as follows hepatocellular 89.9%, cholestatic 2.9%, and mixed 7.2%. Liver biopsies from 55 children most frequently demonstrated chronic (47.3%) and acute (27.3%) hepatitis. Hypersensitivity features, namely, fever (31.9%), rash (21.7%), and eosinophilia (1.4%), were found. Twenty-four children (34.8%) developed chronic DILI. Antibiotics (26.1%) were the most common Western medicines (WMs) causing DILI, and the major implicated herbs were Ephedra sinica and Polygonum multiflorum. Compared with WM, the children whose injuries were caused by Chinese herbal medicine (CHM) showed a higher level of total bilirubin (1.4 mg/dL vs. 16.6 mg/dL, p=0.004) and a longer prothrombin time (11.8 seconds vs. 17.3 seconds, p=0.012), but they exhibited less chronic DILI (2/15 vs. 18/39, p=0.031). CONCLUSIONS:Most cases of DILI in children are caused by antibiotics or CHM used to treat respiratory infection and present with hepatocellular injury. Compared with WM, CHM is more likely to cause severe liver injury, but liver injury caused by CHM is curable.
journal_name
Gut Liverjournal_title
Gut and liverauthors
Zhu Y,Li YG,Wang JB,Liu SH,Wang LF,Zhao YL,Bai YF,Wang ZX,Li JY,Xiao XHdoi
10.5009/gnl14184subject
Has Abstractpub_date
2015-07-01 00:00:00pages
525-33issue
4eissn
1976-2283issn
2005-1212pii
gnl14184journal_volume
9pub_type
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