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Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand

PURPOSE: Pediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF. METHODS: We...

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Autores principales: Getsuwan, Songpon, Lertudomphonwanit, Chatmanee, Tanpowpong, Pornthep, Thirapattaraphan, Chollasak, Tim-Aroon, Thipwimol, Wattanasirichaigoon, Duangrurdee, Treepongkaruna, Suporn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667225/
https://www.ncbi.nlm.nih.gov/pubmed/33215025
http://dx.doi.org/10.5223/pghn.2020.23.6.539
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author Getsuwan, Songpon
Lertudomphonwanit, Chatmanee
Tanpowpong, Pornthep
Thirapattaraphan, Chollasak
Tim-Aroon, Thipwimol
Wattanasirichaigoon, Duangrurdee
Treepongkaruna, Suporn
author_facet Getsuwan, Songpon
Lertudomphonwanit, Chatmanee
Tanpowpong, Pornthep
Thirapattaraphan, Chollasak
Tim-Aroon, Thipwimol
Wattanasirichaigoon, Duangrurdee
Treepongkaruna, Suporn
author_sort Getsuwan, Songpon
collection PubMed
description PURPOSE: Pediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF. METHODS: We retrospectively reviewed the medical records of children (age <15 years) with PALF diagnosed using the American Association for the Study of Liver Diseases criteria at our center from 2011 to 2016. The collected data included laboratory results, complications, outcomes, and potential factors associated with death and LT. RESULTS: We included a total of 27 patients, with a median age of 2 years (interquartile range, 3 months to 4 years). Viral infection was the most common etiology (n=8, 30%), predominantly dengue infection (n=4). A total of 16 patients (59%) died and 11 patients survived (3 patients with LT). The prognostic factors associated with death or LT requirement were grade IV hepatic encephalopathy (p<0.01), hypotension (p=0.02), gastrointestinal bleeding (p=0.03), increased intracranial pressure (p=0.04), and higher peak serum lactate level (p=0.01). Peak serum lactate ≥6 mmoL/L had a sensitivity of 79% and a specificity of 88% for predicting mortality or the necessity of LT. CONCLUSION: Viral infection was the most common cause of PALF. The mortality rate remained high, and a considerable number of patients required LT. In addition to several clinical factors, peak serum lactate could be a potential marker for predicting poor outcomes in PALF.
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spelling pubmed-76672252020-11-18 Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand Getsuwan, Songpon Lertudomphonwanit, Chatmanee Tanpowpong, Pornthep Thirapattaraphan, Chollasak Tim-Aroon, Thipwimol Wattanasirichaigoon, Duangrurdee Treepongkaruna, Suporn Pediatr Gastroenterol Hepatol Nutr Original Article PURPOSE: Pediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF. METHODS: We retrospectively reviewed the medical records of children (age <15 years) with PALF diagnosed using the American Association for the Study of Liver Diseases criteria at our center from 2011 to 2016. The collected data included laboratory results, complications, outcomes, and potential factors associated with death and LT. RESULTS: We included a total of 27 patients, with a median age of 2 years (interquartile range, 3 months to 4 years). Viral infection was the most common etiology (n=8, 30%), predominantly dengue infection (n=4). A total of 16 patients (59%) died and 11 patients survived (3 patients with LT). The prognostic factors associated with death or LT requirement were grade IV hepatic encephalopathy (p<0.01), hypotension (p=0.02), gastrointestinal bleeding (p=0.03), increased intracranial pressure (p=0.04), and higher peak serum lactate level (p=0.01). Peak serum lactate ≥6 mmoL/L had a sensitivity of 79% and a specificity of 88% for predicting mortality or the necessity of LT. CONCLUSION: Viral infection was the most common cause of PALF. The mortality rate remained high, and a considerable number of patients required LT. In addition to several clinical factors, peak serum lactate could be a potential marker for predicting poor outcomes in PALF. The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2020-11 2020-11-05 /pmc/articles/PMC7667225/ /pubmed/33215025 http://dx.doi.org/10.5223/pghn.2020.23.6.539 Text en Copyright © 2020 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Getsuwan, Songpon
Lertudomphonwanit, Chatmanee
Tanpowpong, Pornthep
Thirapattaraphan, Chollasak
Tim-Aroon, Thipwimol
Wattanasirichaigoon, Duangrurdee
Treepongkaruna, Suporn
Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand
title Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand
title_full Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand
title_fullStr Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand
title_full_unstemmed Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand
title_short Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand
title_sort etiologies, prognostic factors, and outcomes of pediatric acute liver failure in thailand
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667225/
https://www.ncbi.nlm.nih.gov/pubmed/33215025
http://dx.doi.org/10.5223/pghn.2020.23.6.539
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