Clinical Feature Of 41 Caces Of Drug Induced Liver Injury In Children

Objectives:To study the clinical features and therapies of DILI in children, Provide help for clinical diagnosis and treatment of DILI。Methods:Retrospectively analysis was applied in 41 children with DILI from gastroenterology department in Children’s hospital of Chongqing medical university from Sept. 2012 to Feb. 2016.Data including medical history, underlying disease, clinical manifestations, vital signs, laboratory findings, complications, therapies and prognosis.Results:(1) The study included 22 males and 19 females mainly aging from 0 to 3 years old(63.4%), And the median age was 2.33 years old.(2) The main drugs causing DILI were the combination therapy for the respiratory tract infection, including antibiotics(22.0%), traditional Chinese medicine(19.5%), analgesic-antipyretic drugs(19.5%), followed by were antituberculotic(9.8%), antiepileptic drugs(4.9%).(3) Main symptoms of children with DILI were hepatomegaly(53.7%), poor spirits and appetite(46.3%), jaundice(34.1%), vomiting(31.7%)and lacking in strength(22.0%), besides, and 41.5 % of children lacked significant clinical manifestations.(4) The most common types of hepatic injury was hepatocellular DILI(80.5%), others include cholestatic DILI(12.2%) and mixed DILI(7.3%).(5) The primary treatment is to stop taking the suspected drug, and be liver protection, removing jaundice, venous nutrition support at the same time; Applying NAC in therapies of children with NO-APAP DILI could not shorten the length of hospitalization.Conclusions:Children, especially infants are prone DILI even acute liver failure. The clinical manifestations of children with DILI lacked in specificity, which suggested that some children developed severe hepatic damage without obvious symptoms. The main drugs causing DILI were the combination therapy for the respiratory tract infection. The primary treatment is to stop taking the suspected drug, and be liver protection, removing jaundice, venous nutrition support at the same time; Applying NAC in therapies of children with NO-APAP DILI could not shorten the length of hospitalization. To diagnose and remedy children with DILI, and avoiding severe DILI, doctors should be acknowledged with side effects of drugs, medical evidence and strictly monitored patients, which means that necessary liver function test was not excluded.