[Hepatotoxicity due to drugs or natural products in children]

An Pediatr (Barc). 2013 Apr;78(4):248-59. doi: 10.1016/j.anpedi.2012.06.012. Epub 2012 Sep 25.
[Article in Spanish]

Abstract

Introduction: The incidence of adverse drug reactions in children has recently been established at 15.1 reactions per 1000 children. This represents 2% of admissions to a paediatric hospital, and is similar to adult patients. Only a small percentage (less than 8%) may have liver involvement, which can range from a slight increase in transaminases to fulminant hepatitis. The aim of this study was to determine the importance (frequency, types of presentation, severity and chronicity) of hepatotoxicity by drugs or natural remedies in the paediatric population.

Patients and method: All paediatric patients, neonates and children who had suspected hepatotoxic reactions notified by the eight participating Spanish hospitals. The Council for International Organizations of Medical Sciences (CIOMS) scale was used for the analysis of causality in each case.

Results and conclusions: We studied a total of 36 hepatotoxic reactions in 33 children. The drug classes most frequently involved were antimicrobials (71%). Amoxicillin-clavulanate was the individual drug responsible for the greatest number of cases (31.4%). We conclude that the registration of drugs associated with liver disease has proved a useful tool for creating an active network of motivated specialists in detecting and reporting incidents of toxic liver disease, ensuring increasing diagnostic accuracy.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Biological Products / adverse effects*
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / epidemiology
  • Chemical and Drug Induced Liver Injury / etiology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Pharmaceutical Preparations
  • Prescription Drugs / adverse effects*
  • Prospective Studies
  • Records

Substances

  • Biological Products
  • Pharmaceutical Preparations
  • Prescription Drugs