{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T01:49:47Z","timestamp":1781056187415,"version":"3.54.1"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2011,10,1]],"date-time":"2011-10-01T00:00:00Z","timestamp":1317427200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2011,9,6]],"date-time":"2011-09-06T00:00:00Z","timestamp":1315267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>\n                                 <jats:bold>Drug-induced liver injury (DILI) is rare in children and adolescents, and, consequently, data are remarkably limited. We analyzed the causes, clinical and biochemical features, natural history, and outcomes of children with DILI. Consecutive children with DILI from 1997 to 2004 (retrospective) and 2005 to 2010 (prospective) were studied based on standard criteria for DILI. Thirty-nine children constituted 8.7% of 450 cases of DILI. There were 22 boys and 17 girls. Median age was 16 years (range, 2.6-17). Combination antituberculous drugs were the most common cause (n = 22), followed by the anticonvulsants, phenytoin (n = 10) and carbamazepine (n = 6). All of the 16 children (41%) who developed hypersensitivity features, such as skin rashes, fever, lymphadenopathy, and\/or eosinophilia, including the 3 with Stevens-Johnson syndrome, survived. Those with hypersensitivity presented earlier (24.5 versus 35 days;<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>= 0.24) had less severe disease (MELD, 16 versus 29;<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>= 0.01) and had no mortality (0\/16 versus 12\/23;<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>&lt; 0.001), compared to those without hypersensitivity. The 12 fatalities were largely the result of antituberculous DILI (n = 11). The presence of encephalopathy and ascites were associated with mortality, along with hyperbilirubinemia, high international normalized ratio, and serum creatinine. According to the Roussel Uclaf Causality Assessment Method, 18 were highly probable, 14 probable, and 7 possible. Thirty-two children were hospitalized.<\/jats:bold>\n                                 <jats:bold>\n                                    Conclusion:\n                                 <\/jats:bold>\n                                 <jats:bold>DILI is not uncommon in children and accounts for 8.7% of all patients with DILI. Antituberculous drugs and anticonvulsants are the leading causes of DILI in India. Overall mortality is high (30.7%), largely accounted by antituberculous drugs. Children with DILI and hypersensitivity features present early, have less severe disease, and, consequently, a better prognosis, compared to those without, and are often associated with anticonvulsants or sulfonamides. (Hepatology 2011;)<\/jats:bold>\n                              <\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.24527","type":"journal-article","created":{"date-parts":[[2011,7,6]],"date-time":"2011-07-06T17:48:25Z","timestamp":1309974505000},"page":"1344-1350","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":75,"title":["Drug-Induced liver injury with hypersensitivity features has a better outcome: A single-center experience of 39 children and adolescents"],"prefix":"10.1097","volume":"54","author":[{"given":"Harshad","family":"Devarbhavi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dheeraj","family":"Karanth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanna","family":"KS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adarsh","family":"CK","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallikarjun","family":"Patil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-26-20241201","doi-asserted-by":"crossref","first-page":"512521","DOI":"10.1016\/j.gastro.2005.05.006","article-title":"; Spanish Group for the Study of DrugInduced Liver Disease. Druginduced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10year period.","volume":"129","author":"Andrade","year":"2005","journal-title":"Gastroenterology"},{"key":"R2-26-20241201","doi-asserted-by":"crossref","first-page":"481489","DOI":"10.1002\/hep.20800","article-title":"Outcome and prognostic markers in severe druginduced liver disease.","volume":"42","author":"Bjornsson","year":"2005","journal-title":"HEPATOLOGY"},{"key":"R3-26-20241201","doi-asserted-by":"crossref","first-page":"19241934","DOI":"10.1053\/j.gastro.2008.09.011","article-title":"; DrugInduced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of druginduced liver injury in the United States.","volume":"135","author":"Chalasani","year":"2008","journal-title":"Gastroenterology"},{"key":"R4-26-20241201","doi-asserted-by":"crossref","first-page":"23962404","DOI":"10.1038\/ajg.2010.287","article-title":"Single center experience with drug induced liver injury from India: causes, outcome, prognosis, and predictors of mortality.","volume":"105","author":"Devarbhavi","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"R5-26-20241201","doi-asserted-by":"crossref","first-page":"465474","DOI":"10.1111\/j.1478-3231.2007.01461.x","article-title":"Druginduced liver injury at an Asian center: a prospective study.","volume":"27","author":"Wai","year":"2007","journal-title":"Liver Int"},{"key":"R6-26-20241201","doi-asserted-by":"crossref","first-page":"652658","DOI":"10.1016\/j.jpeds.2005.12.051","article-title":"Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group.","volume":"148","author":"Squires","year":"2006","journal-title":"J Pediatr"},{"issue":"Suppl","key":"R7-26-20241201","first-page":"10971106","article-title":"Liver.","volume":"113","author":"PineiroCarrero","year":"2004","journal-title":"Pediatrics"},{"key":"R8-26-20241201","doi-asserted-by":"crossref","first-page":"601607","DOI":"10.1097\/00008480-200210000-00007","article-title":"Drugs and the liver: advances in metabolism, toxicity, and therapeutics.","volume":"14","author":"Buratti","year":"2002","journal-title":"Curr Opin Pediatr"},{"key":"R9-26-20241201","first-page":"603606","article-title":"Acute liver failure caused by isoniazid in a child receiving carbamazepine.","volume":"2","author":"Berkowitz","year":"1998","journal-title":"Int J Tuberc Lung Dis"},{"key":"R10-26-20241201","doi-asserted-by":"crossref","first-page":"909911","DOI":"10.1177\/0883073809343474","article-title":"Valproic acidassociated vanishing bile duct syndrome.","volume":"25","author":"Gokce","year":"2010","journal-title":"J Child Neurol"},{"key":"R11-26-20241201","doi-asserted-by":"crossref","first-page":"947954","DOI":"10.7326\/0003-4819-137-12-200212170-00007","article-title":"; U.S. Acute Liver Failure Study Group. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States.","volume":"137","author":"Ostapowicz","year":"2002","journal-title":"Ann Intern Med"},{"key":"R12-26-20241201","doi-asserted-by":"crossref","first-page":"395405","DOI":"10.1097\/MPG.0b013e3181709464","article-title":"Drugrelated hepatotoxicity and acute liver failure.","volume":"47","author":"Murray","year":"2008","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R13-26-20241201","doi-asserted-by":"crossref","first-page":"719729","DOI":"10.1002\/lt.21692","article-title":"Outcome of liver transplantation for druginduced acute liver failure in the United States: analysis of the United Network for Organ Sharing database.","volume":"15","author":"Mindikoglu","year":"2009","journal-title":"Liver Transpl"},{"key":"R14-26-20241201","doi-asserted-by":"crossref","first-page":"337347","DOI":"10.1055\/s-0029-1240002","article-title":"Epidemiology of idiosyncratic druginduced liver injury.","volume":"29","author":"Bell","year":"2009","journal-title":"Semin Liver Dis"},{"key":"R15-26-20241201","doi-asserted-by":"crossref","first-page":"721728","DOI":"10.1111\/j.1365-2125.2010.03754.x","article-title":"Druginduced hepatic injury in children: a casenoncase study of suspected adverse drug reactions in VigiBase.","volume":"70","author":"Ferrajolo","year":"2010","journal-title":"Br J Clin Pharmacol"},{"key":"R16-26-20241201","doi-asserted-by":"crossref","first-page":"13231330","DOI":"10.1016\/0895-4356(93)90101-6","article-title":"Causality assessment of adverse reactions to drugsI. A novel method based on the conclusions of international consensus meetings: application to druginduced liver injuries.","volume":"46","author":"Danan","year":"1993","journal-title":"J Clin Epidemiol"},{"key":"R17-26-20241201","first-page":"272276","article-title":"Criteria of druginduced liver disorders. Report of an international consensus meeting.","volume":"11","author":"Benichou","year":"1990","journal-title":"J Hepatol"},{"key":"R20-26-20241201","doi-asserted-by":"crossref","first-page":"20012009","DOI":"10.1002\/hep.22895","article-title":"Phenotypic characterization of idiosyncratic druginduced liver injury: the influence of age and sex.","volume":"49","author":"Lucena","year":"2009","journal-title":"HEPATOLOGY"},{"key":"R21-26-20241201","doi-asserted-by":"crossref","first-page":"16651674","DOI":"10.1002\/hep.23534","article-title":"Antitubercular therapyinduced acute liver failure: magnitude, profile, prognosis, and predictors of outcome.","volume":"51","author":"Kumar","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R22-26-20241201","doi-asserted-by":"crossref","first-page":"465471","DOI":"10.1378\/chest.99.2.465","article-title":"Toxic hepatitis with isoniazid and rifampin. A metaanalysis.","volume":"99","author":"Steele","year":"1991","journal-title":"Chest"},{"key":"R23-26-20241201","doi-asserted-by":"crossref","first-page":"784786","DOI":"10.1111\/j.1440-1746.2006.04197.x","article-title":"Predisposition of antituberculosis drug induced hepatotoxicity by cytochrome P450 2E1 genotype and haplotype in pediatric patients.","volume":"21","author":"Roy","year":"2006","journal-title":"J Gastroenterol Hepatol"},{"key":"R24-26-20241201","doi-asserted-by":"crossref","first-page":"737738","DOI":"10.1378\/chest.09-2120","article-title":"Risk factors for isoniazid hepatotoxicity in children with latent TB and TB: difference from adults.","volume":"137","author":"Devrim","year":"2010","journal-title":"Chest"},{"key":"R25-26-20241201","doi-asserted-by":"crossref","first-page":"173179","DOI":"10.1097\/01.tp.0000269104.22502.d2","article-title":"Isoniazidrelated hepatic failure in children: a survey of liver transplantation centers.","volume":"84","author":"Wu","year":"2007","journal-title":"Transplantation"},{"key":"R26-26-20241201","doi-asserted-by":"crossref","first-page":"798799","DOI":"10.1002\/hep.23805","article-title":"Antituberculosis therapy druginduced liver injury and acute liver failure.","volume":"52","author":"Devarbhavi","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R27-26-20241201","doi-asserted-by":"crossref","first-page":"20652076","DOI":"10.1002\/hep.23937","article-title":"Druginduced acute liver failure: results of a U.S. multicenter, prospective study.","volume":"52","author":"Reuben","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R28-26-20241201","doi-asserted-by":"crossref","first-page":"615620","DOI":"10.1002\/hep.23317","article-title":"Oral medications with significant hepatic metabolism at higher risk for hepatic adverse events.","volume":"51","author":"Lammert","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R29-26-20241201","doi-asserted-by":"crossref","first-page":"734740","DOI":"10.1038\/clpt.2008.187","article-title":"Personalized therapeutics: HIV treatment in adolescents.","volume":"84","author":"Rakhmanina","year":"2008","journal-title":"Clin Pharmacol Ther"},{"key":"R30-26-20241201","doi-asserted-by":"crossref","first-page":"111133","DOI":"10.2165\/00002018-200225020-00005","article-title":"Clinically significant interactions with drugs used in the treatment of tuberculosis.","volume":"25","author":"Yew","year":"2002","journal-title":"Drug Saf"},{"key":"R31-26-20241201","doi-asserted-by":"crossref","first-page":"13251327","DOI":"10.1056\/NEJM198211183072107","article-title":"Isoniazidinduced carbamazepine toxicity and vice versa: a double drug interaction.","volume":"307","author":"Wright","year":"1982","journal-title":"N Engl J Med"},{"key":"R32-26-20241201","doi-asserted-by":"crossref","first-page":"281290","DOI":"10.1111\/j.1600-0404.2008.01009.x","article-title":"Hepatotoxicity associated with antiepileptic drugs.","volume":"118","author":"Bjornsson","year":"2008","journal-title":"Acta Neurol Scand"},{"key":"R33-26-20241201","doi-asserted-by":"crossref","first-page":"14111421","DOI":"10.1111\/j.1365-2036.2007.03330.x","article-title":"The impact of eosinophilia and hepatic necrosis on prognosis in patients with druginduced liver injury.","volume":"25","author":"Bjornsson","year":"2007","journal-title":"Aliment Pharmacol Ther"},{"key":"R34-26-20241201","doi-asserted-by":"crossref","first-page":"791797","DOI":"10.1016\/j.jhep.2005.12.016","article-title":"Clinical characteristics and prognostic markers in disulfiraminduced liver injury.","volume":"44","author":"Bjornsson","year":"2006","journal-title":"J Hepatol"},{"key":"R35-26-20241201","doi-asserted-by":"crossref","first-page":"485493","DOI":"10.1542\/peds.108.2.485","article-title":"Druginduced hypersensitivity syndrome in pediatric patients.","volume":"108","author":"Carroll","year":"2001","journal-title":"Pediatrics"},{"key":"R36-26-20241201","doi-asserted-by":"crossref","first-page":"675676","DOI":"10.1002\/lt.21753","article-title":"Progress in our understanding of severe druginduced liver injury.","volume":"15","author":"Hayashi","year":"2009","journal-title":"Liver Transpl"},{"key":"R37-26-20241201","doi-asserted-by":"crossref","first-page":"22852290","DOI":"10.1001\/archinte.1995.00430210033005","article-title":"Anticonvulsant hypersensitivity syndrome.","volume":"155","author":"Vittorio","year":"1995","journal-title":"Arch Intern Med"},{"key":"R38-26-20241201","doi-asserted-by":"crossref","first-page":"533538","DOI":"10.1345\/aph.10284","article-title":"Antiepileptic hypersensitivity syndrome in children.","volume":"35","author":"Bessmertny","year":"2001","journal-title":"Ann Pharmacother"},{"key":"R39-26-20241201","doi-asserted-by":"crossref","first-page":"709714","DOI":"10.1517\/14740330903397378","article-title":"Rechallenge in druginduced liver injury: the attractive hazard.","volume":"8","author":"Andrade","year":"2009","journal-title":"Expert Opin Drug Saf"},{"key":"R40-26-20241201","doi-asserted-by":"crossref","first-page":"22162222","DOI":"10.1002\/hep.24022","article-title":"Mitochondrial and immunoallergic injury increase risk of positive drug rechallenge after druginduced liver injury: a systematic review.","volume":"52","author":"Hunt","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R41-26-20241201","doi-asserted-by":"crossref","first-page":"128134","DOI":"10.1172\/JCI113798","article-title":"Anticonvulsant hypersensitivity syndrome: in vitro assessment of risk.","volume":"82","author":"Shear","year":"1988","journal-title":"J Clin Invest"},{"key":"R42-26-20241201","doi-asserted-by":"crossref","first-page":"575584","DOI":"10.1111\/j.1365-2125.2010.03867.x","article-title":"Determinants of mercaptopurine toxicity in paediatric acute lymphoblastic leukemia maintenance therapy.","volume":"71","author":"Adam de Beaumais","year":"2011","journal-title":"Br J Clin Pharmacol"},{"key":"R43-26-20241201","doi-asserted-by":"crossref","first-page":"730742","DOI":"10.1002\/hep.23696","article-title":"Standardization of nomenclature and causality assessment in druginduced liver injury: summary of a clinical research workshop.","volume":"52","author":"Fontana","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R44-26-20241201","doi-asserted-by":"crossref","first-page":"21172126","DOI":"10.1002\/hep.23577","article-title":"; US DrugInduced Liver Injury Network. Causality assessment in druginduced liver injury using a structured expert opinion process: comparison to the RousselUclaf Causality Assessment Method.","volume":"51","author":"Rockey","year":"2010","journal-title":"HEPATOLOGY"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.24527","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.24527","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-201110000-00026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T14:04:30Z","timestamp":1733061870000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-201110000-00026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2011]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.24527","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2011,10]]}}}