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Updated: Sep 7, 2025

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
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Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Published on: January 31, 2022

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Drug-induced Liver Injury in Pediatrics

Fernanda Monge-Urrea1, Ericka Montijo-Barrios

  • 1From the Division of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, Mexico City, Mexico.

Journal of Pediatric Gastroenterology and Nutrition
|June 21, 2022
PubMed

Insights

Drug-induced liver injury (DILI) is a rare cause of pediatric liver disease, often linked to antibiotics and antiepileptics. Prompt drug withdrawal is key for managing DILI in children.

Area of Science:

  • Pediatric Hepatology
  • Clinical Pharmacology
  • Drug Safety and Toxicology

Background:

  • Drug-induced liver injury (DILI) is an underdiagnosed cause of liver disease in children, accounting for approximately 10% of all DILI cases.
  • The exact incidence of DILI in the pediatric population remains unknown.
  • Commonly implicated hepatotoxic medications in children include antibiotics and antiepileptic drugs.

Purpose of the Study:

  • To review the characteristics, diagnosis, and management of drug-induced liver injury in pediatric patients.
  • To highlight the significance of DILI as a cause of liver disease in children.
  • To emphasize the importance of accurate causality assessment and prompt intervention.

Main Methods:

  • Review of existing literature and case reports on pediatric DILI.
  • Discussion of DILI classification (intrinsic vs. idiosyncratic) and injury patterns (hepatocellular vs. cholestatic).
  • Application of the Roussel Uclaf Causality Assessment Method (RUCAM) for diagnosis.

Main Results:

  • DILI presents primarily with hepatocellular or cholestatic injury patterns in children.
  • Antibiotics and antiepileptics are the most frequent culprits.
  • The Roussel Uclaf Causality Assessment Method (RUCAM) aids in diagnosing DILI.

Conclusions:

  • Drug-induced liver injury is a critical consideration in pediatric liver disease.
  • Early identification and withdrawal of the offending agent are paramount for successful treatment.
  • Further research is needed to establish the precise incidence and risk factors for DILI in children.

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