Infantile acute liver failure in the West of Scotland

Wands, David; Tayler, Rachel; Kelly, Déirdre; Pinto, Fernando; Simpson, Judith; Hansen, Richard

doi:10.1136/archdischild-2019-317360

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Currently, effective treatment options for pediatric acute liver failure include medication, arti cial liver support, and even liver transplantation. However, the overall mortality rate of pediatric acute liver failure is reported to range between 20% and 50%, indicating poor clinical outcomes [11][12][13][14]. In this dataset, there were 20 deaths (19.1%), which is consistent with international reports.…”

Section: Discussionsupporting

confidence: 85%

Clinical features analysis of 105 children with liver failure

Chen,

Zheng,

et al. 2024

Preprint

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Objective To study the clinical features of pediatric liver failure and provide reference for diagnosis and prevention. Methods Clinical data of children diagnosed with liver failure at XX Hospital from 2012 to 2023 were collected and statistically analyzed. Results Among 105 cases of liver failure in children, the age ranged from 1 day to 14 years and 11 months, with a median age of 1 year and 9 months. There were 67 males and 38 females, with acute and subacute liver failure accounting for 82.8%. The most common causes were hereditary metabolic diseases (24 cases, 22.9%), followed by infection factors (12 cases, 11.4%), and biliary diseases (10 cases, 9.5%). However, the cause remained unknown in 34.3% of cases. The most common clinical manifestations were poor appetite, fever, and jaundice. The main complications were hepatic encephalopathy, electrolyte disorders, and infection. There was no statistically significant difference in age, albumin, blood ammonia, presence of hepatic encephalopathy, ALT, and GGT between the survival group and the 28-day mortality group (P>0.05). The survival group had lower PELD/MELD scores, total bilirubin, and INR, and higher platelet count compared to the 28-day mortality group, with statistically significant differences (P<0.05). Conclusion Hereditary metabolic diseases, infection, and biliary diseases are common causes of pediatric liver failure. MELD/PELD scores can predict the prognosis of liver failure. Clinical feature analysis and MELD/PELD scores are helpful in guiding clinical diagnosis, treatment, and prognosis assessment.

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Section: Discussionsupporting

confidence: 85%

Clinical features analysis of 105 children with liver failure

Chen,

Zheng,

et al. 2024

Preprint

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“…These findings are in contrast to our results. 10,12 Common viral infections, which can lead to ALFI in infants, are EBV, CMV, HSV type 1, HBV or echovirus. Common bacterial agents isolated in this age group are enterococcus and Gram-negative bacilli like Escherichia Coli, Proteus or Klebsiella.…”

Section: Resultsmentioning

confidence: 99%

Etiological and Clinical Spectrum of Acute Liver Failure of Infancy in Pakistan

Sarwar

Cheema

Anwar

et al. 2023

PAFMJ

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Objective: To describe the aetiology and clinical spectrum of acute liver failure of infancy at a tertiary care hospital Study Design: Cross-sectional study. Place and Duration of Study: Department of Paediatric Gastroenterology, Hepatology & Nutrition, Children Hospital and Institute of Child Health, Lahore, from Nov 2020 to May 2021. Methodology: Infants under 12 months of age were enrolled having liver-based coagulopathy (not corrected after two doses of parenteral vitamin K, 10 mg) with INR > 2, whether encephalopathy was present or not. Encephalo-pathy is difficult to identify in infants, so it was not essential for the diagnosis of ALFI in our study. Infants diagnosed with chronic liver disease at presentation or those without final etiological diagnosis were excluded. Results: A total of 31 infants were enrolled fulfilling the criteria of acute liver failure of infancy and were studied about aetiology and clinical presentation. The mean age of presentation was 4.64±3.16 months, and males predominated in the study group (64.5%). Common clinical features were in descending order ascites in 29 (93.5%), jaundice in 28 (90.3%), pallor in 24 (77.4%) and peripheral oedema in 21 (67.7%). Metabolic liver diseases were the common cause of ALFI, constituting around(18, 58%) followed by sepsis (9, 29%).Galactosemia (11, 35.5%) stands out among the metabolic causes. Conclusion: Metabolic disorders followed by sepsis are the most common cause of ALFI.

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“…A total of 32 articles (published between 1997–2019) met inclusion criteria and were analyzed for this study. Table 2 [ 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 ] summarizes the data extracted from these studies. A total of 2,989 subjects were included in our analysis (2,019 from developed countries and 970 from developing countries), with an age range of 0–22 years old.…”

Section: Resultsmentioning

confidence: 99%

“…39.7% (95% CredI 37.6-41.9) of the causes were of indeterminate origin. Of the 970 children in developing countries, the most frequent cause of PALF was Hepatitis A (28.9%; https://pghn.org https://doi.org/10.5223/pghn.2020.23.6.501 [40] 2016 Retrospective Argentina Developing 1.9 Sanchez [41] 2012 Retrospective Argentina Developing 1.3 Silverio [42] 2015 Prospective Cuba Developing 1.0 Tung [43] 2000 Retrospective London Developed 2.5 Wands [44] 2018 Retrospective Scotland Developed 0.8 Yankol [45] 2016 Retrospective Turkey Developing 0.7 *Rounded to nearest 0.1%. 95% CredI 26.3-31.7), followed by unspecified infection (9.52%; 95% CredI 7.86-11.3) and Wilson's disease (7.78%; 95% CredI 6.27-9.44).…”

Section: Figurementioning

confidence: 99%

Differential Diagnosis of Acute Liver Failure in Children: A Systematic Review

Berardi

Tuckfield

DelVecchio

et al. 2020

Pediatr Gastroenterol Hepatol Nutr

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Purpose To develop a probability-based differential diagnosis for pediatric acute liver failure (PALF) based on age and socioeconomic status of the country of origin. Methods Comprehensive literature search using PubMed, EMBASE, and SCOPUS databases was performed. Children 0–22 years of age who met PALF registry criteria were included. Articles included >10 children, and could not be a case report, review article, or editorial. No language filter was utilized, but an English abstract was required. Etiology of PALF, age of child, and country of origin was extracted from included articles. Results 32 full text articles were reviewed in detail; 2,982 children were included. The top diagnosis of PALF in developed countries was acetaminophen toxicity (9.24%; 95% CredI 7.99–10.6), whereas in developing countries it was Hepatitis A (28.9%; 95% CredI 26.3–31.7). In developed countries, the leading diagnosis of PALF in children aged <1 year was metabolic disorder (17.2%; 95% CredI 10.3–25.5), whereas in developing countries it was unspecified infection (39.3%; CredI 27.6–51.8). In developed countries, the leading diagnosis in children aged >1 year was Non-A-B-C Hepatitis (8.18%; CredI 5.28–11.7), whereas in developing countries it was Hepatitis A (32.4%; CredI 28.6–36.3). Conclusion The leading causes of PALF in children aged 0-22 years differ depending on the age and developmental status of their country of origin, suggesting that these factors must be considered in the evaluation of children with PALF.

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Infantile acute liver failure in the West of Scotland

Cited by 5 publications

References 5 publications

Clinical features analysis of 105 children with liver failure

Clinical features analysis of 105 children with liver failure

Etiological and Clinical Spectrum of Acute Liver Failure of Infancy in Pakistan

Differential Diagnosis of Acute Liver Failure in Children: A Systematic Review

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