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Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...

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Updated: Jun 10, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
11:06

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

Published on: January 31, 2022

Drug Induced Liver Injury in Children: Practical Considerations for Pathologists.

Kalyani R Patel1, Juan Putra2

  • 1Department of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
|June 9, 2026
PubMed
Summary
This summary is machine-generated.

Diagnosing drug-induced liver injury (DILI) in children is challenging. This review covers DILI patterns, common drug culprits like antimicrobials, and liver biopsy interpretation for accurate diagnosis.

Keywords:
Lafora-like inclusionsacute cholestasisdrugshepatitisvanishing bile duct syndrome

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Area of Science:

  • Pediatric Hepatology
  • Toxicology
  • Gastroenterology

Background:

  • Drug-induced liver injury (DILI) in children presents a complex diagnostic challenge due to diverse clinical and histological manifestations.
  • DILI is categorized by pathogenesis into idiosyncratic, intrinsic (direct), or indirect types.
  • Antimicrobials and antiepileptic drugs are frequently implicated agents in the United States.

Purpose of the Study:

  • To review the primary morphologic patterns of pediatric DILI.
  • To identify commonly associated causative agents.
  • To provide practical guidance for interpreting liver biopsies in DILI cases.

Main Methods:

  • This is a review article, synthesizing existing literature on pediatric DILI.
  • Focuses on clinicopathologic correlation for diagnosis and causality assessment.
  • Highlights the role of liver biopsy in characterizing injury, assessing severity, and ruling out differential diagnoses.

Main Results:

  • Histologic features in pediatric DILI are often nonspecific, necessitating clinicopathologic correlation.
  • Liver biopsy, while not always essential, aids in characterizing injury patterns and severity.
  • Commonly implicated agents include antimicrobials and antiepileptic medications.

Conclusions:

  • Accurate diagnosis of pediatric DILI requires careful clinicopathologic correlation.
  • Understanding morphologic patterns and associated agents is crucial for effective management.
  • Liver biopsy interpretation is a key component in diagnosing and managing DILI in children.