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Archivos argentinos de pediatría

Print version ISSN 0325-0075On-line version ISSN 1668-3501


CAVALIERI, María L  and  D'AGOSTINO, Daniel. Drug-, herb- and dietary supplement-induced liver injury. Arch. argent. pediatr. [online]. 2017, vol.115, n.6, pp.e397-e403. ISSN 0325-0075.

Drug- and substance-induced liver injury accounts for approximately 20% of pediatric cases of acute liver failure. It is caused by two mechanisms: direct and idiosyncratic hepatotoxicity. Direct hepatotoxicity is the result of the administration of a drug with intrinsic toxicity and is dose-dependent (e.g., acetaminophen). Idiosyncratic hepatotoxicity is unpredictable, uncommon, variable in presentation, and doseindependent. The clinical, histological, and laboratory manifestations include hepatitis, which is generally asymptomatic but with a significant increase of liver enzymes; cholestasis, accompanied with jaundice, pruritus, prominent elevation of alkaline phosphatase, and mild elevation of aminotransferases; or mixed, with elements of both hepatitis and cholestasis. Time to recovery is variable, depending on the type of liver injury. Early detection and discontinuation of the causative drug is the most effective and important step for the fast resolution of histological and clinical changes, thus reducing severe liver injury.

Keywords : Drug-induced liver injury.

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