Acute Liver Failure, Pediatric

Reviewed 06/2017
 


Basics

Description

  • A set of criteria has been proposed to diagnose pediatric acute liver failure (ALF).

    • Biochemical evidence of liver injury due to rapid loss of hepatocyte function

    • No previous history o...

Diagnosis

History

  • Age: may suggest possible etiologic subgroup

  • Toxin exposure: prescription, over-the-counter, herbal, or supplemental medications

  • Symptoms of viral prodrome

  • Travel history, exposure histo...

Treatment

Medication

  • Hematologic

    • Vitamin K: Administer IV or SQ/IM for prolonged PT/INR, and monitor response with repeat PT/INR 4–6 hours afterward.

    • FFP and cryoprecipitate should be reserved for acute ...

Ongoing Care

Prognosis

  • Etiology of ALF provides good indicator of prognosis and also dictates management.

  • Existing liver failure scoring systems based on biochemical markers (e.g., INR) and/or clinical ...

Additional Reading

  • Bass  NM, Mullen  KD, Sanyal  A, et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med.  2010;362(12):1071–1081. [View Abstract]

  • Bucuvalas  J, Yazigi  N, Squires  R...

Codes

ICD09

  • 570 Acute and subacute necrosis of liver

ICD10

  • K72.00 Acute and subacute hepatic failure without coma

  • K71.10 Toxic liver disease with hepatic necrosis, without coma

SNOMED

  • 197270009 Acute hepati...

FAQ

  • Q: What are the most common causes of ALF in infants?

  • A: Up to 40–50% of cases are indeterminate, followed by neonatal hemochromatosis, viral infection, and metabolic disorders.

  • Q: What is the risk ...

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