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Acute liver failure secondary to toxic exposure in children

Alina Grama1,2, Cornel Aldea3, Lucia Burac1

  • 12 Paediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.

Archives of Medical Science : AMS
|February 14, 2022
PubMed

Insights

Acute liver failure (ALF) in children is often caused by toxins. While mushroom poisoning leads to high mortality, drug-induced ALF is a growing concern, particularly from acetaminophen overdose.

Area of Science:

  • Pediatric Toxicology
  • Hepatology
  • Environmental Health

Background:

  • Acute liver failure (ALF) is characterized by jaundice, coagulopathy, and hepatic encephalopathy in individuals without pre-existing liver disease.
  • Toxins and medications are common triggers for ALF in pediatric populations.

Purpose of the Study:

  • To identify the primary causes of toxic acute liver failure in children treated at a major pediatric toxicology center in Romania.
  • To analyze trends in toxic ALF etiology from January 2000 to August 2018.

Main Methods:

  • Retrospective analysis of hospital records for pediatric patients diagnosed with toxic ALF.
  • Inclusion criteria: ALF diagnosis following mushroom or drug exposure.

Main Results:

  • 123 pediatric patients with toxic ALF were admitted over 18 years: 89 from mushroom ingestion, 34 from drug exposure.
  • Mushroom poisoning was the leading cause until 2012; drug-induced ALF, particularly from acetaminophen, has increased significantly.
  • Acetaminophen was the most frequent drug implicated in toxic ALF (52.94%).

Conclusions:

  • Mushroom poisoning-related ALF carries a high mortality rate in children and is a significant cause of death.
  • Limited access to emergency liver transplantation poses a challenge for Eastern European pediatric centers.
  • There is a concerning rise in drug-induced ALF, often linked to intentional overdoses or lax prescription practices for hepatotoxic drugs.
Abstract

Keywords:
acute liver failurechildrendrugslivermushroomstoxic

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