Clinical characteristics and outcomes of drug-induced liver injury in children: a study of 184 cases / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the clinical characteristics and outcomes of drug-induced liver injury (DILI) in children, and to improve the understanding of DILI in children. MethodsOne hundred and eighty-four children with DILI who were under 16 years and hospitalized in our hospital from January 2004 to January 2014 were enrolled as subjects, and their clinical and pathological data were retrospectively analyzed. ResultsDILI might occur at any age in children, even at the infant stage, and the youngest patient was only 2 months old. There were 143 patients (77.7%) with clinical symptoms, including loss of appetite, jaundice, and yellow urine. The drugs causing DILI included traditional Chinese medicine (28.3%), antibiotics (24.5%), and anti-inflammatory drugs (19.6%). The pathological characteristics of DILI in children included eosinophils-based inflammatory cell infiltration (78.7%), mixed hepatic steatosis (73.5%), and cholangiolar cholestasis (38.7%). Four patients (2.2%) developed autoimmune hepatitis; twenty-nine patients(158%) had liver failure, and three of them died of liver failure. After treatment, 177 patients (96.2%) recovered normal liver function and were discharged. ConclusionDILI may occur at any age in children, and a majority of drugs causing DILI are traditional Chinese medicine, antibiotics, and anti-inflammatory drugs. The pathological examination of liver provides an important basis for the diagnosis of DILI in children. In spite of the benign prognosis in most patients, the incidence of liver failure still needs to be taken into account, and regular follow-up is necessary.