Etiology y, outcome and prognostic factors of childhood acute liver failure in a German Single Center



Título del documento: Etiology y, outcome and prognostic factors of childhood acute liver failure in a German Single Center
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000391016
ISSN: 1665-2681
Autores: 1
1
1
1
1
1
1
1
2
1
Instituciones: 1University of Duisburg-Essen, Essen, Nordrhein-Westfalen. Alemania
2University of California, Department of Pediactrics, San Diego, California. Estados Unidos de América
Año:
Periodo: Sep-Oct
Volumen: 14
Número: 5
Paginación: 722-728
País: México
Idioma: Inglés
Tipo de documento: Estadística o encuesta
Enfoque: Caso clínico
Resumen en inglés Pediatric acute liver failure (PALF) is a progressive, potentially fatal clinical syndrome occurring in previously healthy children. Our study aimed to determine the current leading causes of PALF in a single center in Germany, identifying possible prognostic markers. Thirty-seven pediatric patients with PALF were included. Medical records were reviewed for demographic, laboratory and clinical data. Laboratory results on admission and at peak value, PELD and MELD score on admission, and intensive care support were assessed. Fifteen patients recovered spontaneously, 14 died without transplantation, and 8 received a liver transplant. Patients who survived were significantly older than patients who died. Specific causes of PALF could be identified as infectious diseases (16%), metabolic diseases (14%), toxic liver injury (11%), immunologic diseases (8%), or vascular diseases (8%). Causes of PALF remained indeterminate in 43%. High ammonia, low albumin, and low ALT levels on admission were associated with worse outcome. Absence of need of ventilation, hemodialysis, and circulatory support predicted spontaneous recovery. In conclusion, infections are the most common known cause of PALF. However, in a large proportion of patients the cause for PALF remains cryptic. Ammonia and albumin levels may be of prognostic value to predict outcomes
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Gastroenterología,
Insuficiencia hepática aguda,
Amoníaco,
Niños,
Etiología,
Pronóstico
Keyword: Medicine,
Diagnosis,
Gastroenterology,
Acute liver failure,
Ammonia,
Children,
Etiology,
Prognosis
Texte intégral: Texto completo (Ver PDF)