2026-05-30T08:09:46Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/378072026-02-03T10:57:50Zcom_10630_2254col_10630_37953

Therapeutic management of idiosyncratic drug‑induced liver injury and acetaminophen hepatotoxicity in the paediatric population: a systematic review. Niu, Hao Atallah, Edmond Álvarez-Álvarez, Ismael Medina-Cáliz, Inmaculada Aithal, Guruprasad P. Arikan, Cigdem Andrade-Bellido, Raúl Jesús Lucena-González, María Isabel Hígado - Heridas y lesiones Hepatotoxicidad 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. 2025-02-12T11:34:17Z 2025-02-12T11:34:17Z 2022 journal article 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 https://hdl.handle.net/10630/37807 10.1007/s40264-022-01224-w eng http://creativecommons.org/licenses/by/4.0/ open access Attribution 4.0 Internacional Springer Nature