RT Journal Article
T1 Therapeutic management of idiosyncratic drug‑induced liver injury and acetaminophen hepatotoxicity in the paediatric population: a systematic review.
A1 Niu, Hao
A1 Atallah, Edmond
A1 Álvarez-Álvarez, Ismael
A1 Medina-Cáliz, Inmaculada
A1 Aithal, Guruprasad P.
A1 Arikan, Cigdem
A1 Andrade-Bellido, Raúl Jesús
A1 Lucena-González, María Isabel
K1 Hígado - Heridas y lesiones
K1 Hepatotoxicidad
AB Introduction: Drug-induced liver injury (DILI) is a rare but serious adverse event that can progress to acute liver failure (ALF). The evidence for treatment of DILI in children is scarce.Objective: We aim to comprehensively review the available literature on the therapies for both acetaminophen overdoses (APAP) and idiosyncratic DILI in the paediatric population. Methods: We included original articles conducted in paediatric population (<18 years) in which a therapeutic intervention was described to manage APAP or idiosyncratic DILI. Findings were summarized based on age groups (preterm newborn neonates, term and post-term neonates, infants, children, and adolescents.Results: Overall, 25 publications (fifteen case reports, six case series, and four retrospective cohort studies) were retrieved, including a total of 140 paediatric DILI cases, from preterm newborn neonates to adolescents. N-acetylcysteine was used to treat 19 APAP cases. N-acetylcysteine (n=14), ursodeoxycholic acid (n=3), corticosteroids (n=31), carnitine (n=16), and the combination of glycyrrhizin, reduced glutathione, polyene phosphatidylcholine and S-adenosylmethionine (n=31), were the therapeutic options for treating idiosyncratic DILI. Molecular adsorbent recirculating system was used in the management of either APAP (n=4) or idiosyncratic DILI (n=2), while 20 paediatric ALF cases received continuous renal replacement therapy.Conclusions: This systematic review identified DILI in the paediatric population which have received specific treatment. These interventions appear to be mainly extrapolated from low-quality evidence from the adult population. Thus, there is a need of high-quality studies to test the efficacy of known and novel therapies to treat DILI specifically addressed to the paediatric population.PROSPERO registration number CRD42021214702.
PB Springer Nature
YR 2022
FD 2022
LK https://hdl.handle.net/10630/37807
UL https://hdl.handle.net/10630/37807
LA eng
NO Niu H, Atallah E, Alvarez-Alvarez I, Medina-Caliz I, Aithal GP, Arikan C, Andrade RJ, Lucena MI. Therapeutic management of idiosyncratic drug-induced liver injury and acetaminophen hepatotoxicity in the paediatric population: a systematic review. Drug Saf. 2022;45(11):1329-1348
NO The present study has been supported by grants of Instituto de Salud Carlos III (ISCIII) cofounded by Fondo Europeo de Desarrollo Regional - FEDER (contract numbers: PI21/01248; PT20/000127), Consejería de Salud de Junta de Andalucía (contract number: PI-0310-2018), and Agencia Española del Medicamento. CIBERehd and Plataforma ISCIII Ensayos Clínicos are funded by ISCIII. HN holds a postdoctoral research contract funded by Junta de Andalucia (POSTDOC_21_00780). I.A.-A. holds a Sara Borrell contract funded by ISCIII (CD20/00083). This article/publication is based upon work from COST Action CA17112, supported by COST (European Cooperation in Science and Technology). www.cost.eu.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 13 abr 2026