title: [Clinical characteristics of drug-induced liver injury in 31 pediatric cases].
abstract: OBJECTIVE
  To investigate the clinical characteristics and responsible agents of drug-induced liver injury (DILI) in pediatric patients.
  
  
  METHODS
  Thirty-one cases of DILI treated in our hospital's pediatric ward were retrospectively analyzed. The clinical data for each patient were extracted from the patient's medical records, and included reported causes, physical and biochemical features, natural history, blood examination results, and hepatic pathology findings.
  
  
  RESULTS
  The 31 pediatric cases of DILI accounted for 1.7% of the 1831 total cases of drug-induced liver injury treated at our hospital between February 2002 to June 2011. The pediatric DILI population was composed of 20 males and 11 females, with an average age of 8.8+/-3.9 years old (range, 0.3-14.0). The liver injury patterns represented among the cases were: hepatocellular (25.8%), cholestasis (25.8%), and mixed hepatocellular-cholestatic (48.4%). Antimicrobials were the most common cause (41.9%) of DILI, followed by the herbal medicine (29.0%) and febrifuge drugs (19.4%). A single drug was implicated in nine cases (29.0%), and two or more drugs were implicated in 22 cases (71%). Most of the children had good prognosis, but those with pre-existing disease had poor prognosis. One child died of hepatic failure, making the death rate 3.23%. The average hospitalization time was 25.2 days, and the patients with hepatocellular injury had shorter hospitalization time than those with mixed injury.
  
  
  CONCLUSIONS
  Drug-induced liver injury in our pediatric population was most often caused by antimicrobials, followed by herbal medicine and febrifuge drugs. Most patients presented with mixed hepatocellular-cholestatic injury. Children with pre-existing diseases or hepatic failure had poor prognosis.
authors.affiliation: Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Shu-zhen
authors.initials: SZ
authors.lastname: Wang
authors.forename: Shan
authors.initials: S
authors.lastname: Gao
authors.forename: Yan-min
authors.initials: YM
authors.lastname: Liu
authors.forename: Yun-li
authors.initials: YL
authors.lastname: Huang
authors.forename: Yi-shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Xin-xin
authors.initials: XX
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Lin
authors.forename: Chun-yang
authors.initials: CY
authors.lastname: Huang
authors.forename: Hui-yu
authors.initials: HY
authors.lastname: Liao
mesh_terms: D000293:Adolescent; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies