P0261 Liver Disease in Vietnamese Children

Tran, Huong T.; Vo, Hong; Tran, An; Nguyen, Thi Thanh Hai

doi:10.1097/00005176-200406001-00385

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“…Hepatitis A virus is the most common cause of PALF in the Philippines [18]. Similarly, Tran et al [19] have reported that hepatitis A and B are the major causes of liver disease in Vietnamese children. The relatively low prevalence of viral hepatitis A and B in Thailand probably resulted from improvements in sanitation and immunization.…”

Section: Discussionmentioning

confidence: 99%

Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand

Getsuwan

Lertudomphonwanit

Tanpowpong

et al. 2020

Pediatr Gastroenterol Hepatol Nutr

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Purpose Pediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF. Methods We retrospectively reviewed the medical records of children (age <15 years) with PALF diagnosed using the American Association for the Study of Liver Diseases criteria at our center from 2011 to 2016. The collected data included laboratory results, complications, outcomes, and potential factors associated with death and LT. Results We included a total of 27 patients, with a median age of 2 years (interquartile range, 3 months to 4 years). Viral infection was the most common etiology (n=8, 30%), predominantly dengue infection (n=4). A total of 16 patients (59%) died and 11 patients survived (3 patients with LT). The prognostic factors associated with death or LT requirement were grade IV hepatic encephalopathy ( p <0.01), hypotension ( p =0.02), gastrointestinal bleeding ( p =0.03), increased intracranial pressure ( p =0.04), and higher peak serum lactate level ( p =0.01). Peak serum lactate ≥6 mmoL/L had a sensitivity of 79% and a specificity of 88% for predicting mortality or the necessity of LT. Conclusion Viral infection was the most common cause of PALF. The mortality rate remained high, and a considerable number of patients required LT. In addition to several clinical factors, peak serum lactate could be a potential marker for predicting poor outcomes in PALF.

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Section: Discussionmentioning

confidence: 99%