Acute Liver Failure in Children

Robert H. Squires

doi:10.1055/s-2008-1073115

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2008; 28(2): 153-166
DOI: 10.1055/s-2008-1073115

Acute Liver Failure in Children

Robert H. Squires¹ Jr.

¹Professor of Pediatrics, University of Pittsburgh; and Clinical Director of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

Abstract

ABSTRACT

Acute liver failure (ALF) in children differs from that observed in adults in both the etiologic spectrum and the clinical picture. Children, particularly very young ones, do not demonstrate classical features of encephalopathy and the definition of ALF has been revised to include patients with advanced coagulopathy, regardless of mental status. A significant number of these children will go on to require transplant or die. Etiologies vary by age with metabolic and infectious diseases prominent in the first year of life and acetaminophen overdose and Wilson's disease occurring in adolescents. In almost 50% of cases, however, the child has an indeterminate cause for ALF. Management requires a multidisciplinary approach and is directed at establishing the etiology where possible and monitoring, anticipating, and managing the multisystem complications that occur in children with ALF. Overall, short-term outcomes are better in children than adults but are dependent upon the degree of encephalopathy and diagnosis.

KEYWORDS

Acute liver failure - acetaminophen - hepatitis - APAP

Full Text

References

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Robert H SquiresJr. M.D.

Clinical Director of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Pittsburgh

3705 Fifth Avenue, Pittsburgh, PA 15213

Email: squiresr@upmc.edu