title: [Hepatotoxicity due to drugs or natural products in children].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  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.
authors.affiliation: UGC médico quirúrgica de la infancia, Hospital Universitario Virgen de las Nieves, Granada, España. estherocete@ugr.es
authors.forename: E
authors.initials: E
authors.lastname: Ocete Hita
authors.forename: J A
authors.initials: JA
authors.lastname: Martín García
authors.forename: F
authors.initials: F
authors.lastname: Giménez Sánchez
authors.forename: J C
authors.initials: JC
authors.lastname: Flores González
authors.forename: A
authors.initials: A
authors.lastname: Abril Molina
authors.forename: J
authors.initials: J
authors.lastname: Salmerón Escobar
authors.forename: A
authors.initials: A
authors.lastname: Ruiz Extremera
mesh_terms: D000293:Adolescent; D001688:Biological Products / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D004364:Pharmaceutical Preparations; D055553:Prescription Drugs / Q000009:adverse effects*; D011446:Prospective Studies; D011996:Records
chemical_list: D001688:Biological Products; D004364:Pharmaceutical Preparations; D055553:Prescription Drugs