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Etiology, outcome and prognostic factors of childhood acute liver failure in a German Single Center.
Kathemann, Simone; Bechmann, Lars P; Sowa, Jan-Peter; Manka, Paul; Dechêne, Alexander; Gerner, Patrick; Lainka, Elke; Hoyer, Peter F; Feldstein, Ariel E; Canbay, Ali.
Afiliação
  • Kathemann S; Department of Pediatrics II, University Hospital, University Duisburg-Essen, Essen, Germany.
  • Bechmann LP; Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany.
  • Sowa JP; Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany.
  • Manka P; Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany.
  • Dechêne A; Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany.
  • Gerner P; Department of Pediatrics II, University Hospital, University.
  • Lainka E; Department of Pediatrics II, University Hospital, University.
  • Hoyer PF; Department of Pediatrics II, University Hospital, University.
  • Feldstein AE; Department of Pediatrics, University of California San Diego (UCSD), CA, USA.
  • Canbay A; Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany.
Ann Hepatol ; 14(5): 722-8, 2015.
Article em En | MEDLINE | ID: mdl-26256901
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.
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Falência Hepática Aguda Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: Ann Hepatol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Alemanha País de publicação: México
Buscar no Google
Adicionar na Minha BVS
Imprimir
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PubMed Links

Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Falência Hepática Aguda Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: Ann Hepatol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Alemanha País de publicação: México