Drug-induced liver injury in children: A nationwide cohort study from China

Lai, Rongtao1; Li, Xinjie2,3; Zhang, Jie4; Chen, Jun5; Yang, Changqing6; Xie, Wen7; Yu, Yuecheng8,9; Guo, Xiaoyan10; Zhang, Xinrong11; Lu, Guoliang12; Han, Xi'an13; Xie, Qing1; Chen, Chengwei14; Shen, Tao2,3; Mao, Yimin15,16

2024-08-01

10.1016/j.jhepr.2024.101102

JHEP REPORTS   影响因子和分区

2589-5559

Background & Aims: Currently, there is limited knowledge on the clinical profile of drug-induced liver injury (DILI) in Chinese children. We aimed to assess the clinical characteristics, suspected drugs, and outcomes associated with pediatric DILI in China. Methods: This nationwide, multicenter, retrospective study, conducted between 2012 and 2014, analyzed 25,927 cases of suspected DILI at 308 medical centers using the inpatient medical register system. Utilizing the Roussel Uclaf causality assessment method score, only patients with scores >= 6 or diagnosed with DILI by three experts after scoring <6 were included in the analysis. Among them, 460 cases met the EASL biochemical criteria. The study categorized children into three age groups: toddlers (>= 30 days to <6 years old), school-age children (6 to <12 years old), and adolescents (12 to <18 years old). Results: Hepatocellular injury was the predominant clinical classification, accounting for 63% of cases, with 34% of these cases meeting Hy's law criteria. Adolescents comprised the majority of children with moderate/severe DILI (65%). Similarly, adolescents faced a significantly higher risk of severe liver injury compared to younger children (adjusted odd ratios 4.75, p = 0.002). The top three most frequently prescribed drug classes across all age groups were antineoplastic agents (25.9%), antimicrobials (21.5%), and traditional Chinese medicine (13.7%). For adolescents, the most commonly suspected drugs were antitubercular drugs (22%) and traditional Chinese medicine (23%). Conclusion: Adolescents are at a greater risk of severe and potentially fatal liver injury compared to younger children. Recognizing the risk of pediatric DILI is crucial for ensuring safe medical practices. (c) 2024 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).

Chemical and drug induced liver injury Adolescents Antineoplastic agent Traditional Chinese medicine

SCI

英语

其他

Major Project of the National Thirteenth Five Plan[2017ZX09304016] ; National Natural Science Foundation of China["81970513","81970514","82270619"] ; Key projects of Shanghai Health Commission[202040111] ; Shanghai Municipal Key Clinical Specialty[shslczdzk01103]

Gastroenterology & Hepatology

Gastroenterology & Hepatology

WOS:001267978000001

ELSEVIER

Web of Science

1.Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Dept Infect Dis, Shanghai, Peoples R China
2.Peking Univ, Hlth Sci Ctr, Dept Microbiol, Beijing, Peoples R China
3.Peking Univ, Ctr Infectious Dis, Hlth Sci Ctr, Sch Basic Med Sci, Beijing, Peoples R China
4.Shanghai Gen Hosp, Dept Pediat, Shanghai, Peoples R China
5.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Affiliated Hosp 2, Dept Liver Dis, Shenzhen 518100, Guangdong, Peoples R China
6.Tongji Univ, Shanghai Tongji Hosp, Sch Med, Dept Gastroenterol & Hepatol, Shanghai, Peoples R China
7.Capital Med Univ, Beijing Ditan Hosp, Ctr Liver Dis, Beijing, Peoples R China
8.Nanjing Univ, Dept Infect Dis, Nanjing, Peoples R China
9.Nanjing Univ, Gen Hosp Eastern Theater Command, Jinling Hosp, Ctr Hepatol,Sch Med, Nanjing, Peoples R China
10.Xi An Jiao Tong Univ, Affiliated Hosp 2, Dept Gastroenterol, Xian, Peoples R China
11.Stanford Univ, Sch Med, Div Gastroenterol & Hepatol, Palo Alto, CA 94305 USA
12.Peoples Hosp Anshun City, Dept Neonatol, Guizhou, Peoples R China
13.Unimed Sci, Wuxi, Peoples R China
14.905 Hosp, Liver Dis Ctr No, Shanghai 200235, Peoples R China
15.Shanghai Jiao Tong Univ, Renji Hosp, Shanghai Inst Digest Dis, Sch Med, Shanghai 200001, Peoples R China
16.Shanghai Jiao Tong Univ, Clin Res Ctr, Sch Med, Shanghai, Peoples R China

Lai, Rongtao,Li, Xinjie,Zhang, Jie,et al. Drug-induced liver injury in children: A nationwide cohort study from China[J]. JHEP REPORTS,2024,6(8).

Lai, Rongtao.,Li, Xinjie.,Zhang, Jie.,Chen, Jun.,Yang, Changqing.,...&Mao, Yimin.(2024).Drug-induced liver injury in children: A nationwide cohort study from China.JHEP REPORTS,6(8).

Lai, Rongtao,et al."Drug-induced liver injury in children: A nationwide cohort study from China".JHEP REPORTS 6.8(2024).