{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:02:47Z","timestamp":1785164567247,"version":"3.55.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pediatric acute liver failure can result from infections, metabolic disorders, autoimmune diseases, toxins, or malignancies. It is crucial to consider herbal medicines as an etiological factor in such cases. We report a 7-year-old boy presenting with PALF from arsenic toxicity after consuming herbal medicine. He presented with jaundice, fever, vomiting, and lethargy, with hepatomegaly and signs of raised intracranial tension on examination. He had taken herbal medicine for the jaundice. His toxicology screen revealed high levels of arsenic and lead in serum and urine. Whole exome sequencing incidentally identified pathogenic mutations of the SLCO1B1 and SLCO1B3 genes, suggestive of Rotor syndrome (RS). Despite intensive care, including continuous renal replacement therapy and plasmapheresis, he died from multiorgan dysfunction and sepsis. This case shows the risks of unregulated herbal formulations containing toxins and explores the potential interaction between RS and arsenic toxicity.<\/jats:p>","DOI":"10.1093\/omcr\/omag111","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:52:12Z","timestamp":1783518732000},"source":"Crossref","is-referenced-by-count":0,"title":["Pediatric acute liver failure in a child with arsenic toxicity and underlying rotor syndrome"],"prefix":"10.1093","volume":"2026","author":[{"given":"Shivangi","family":"Tetarbe","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology, Bai Jerbai Wadia Hospital for Children , Acharya Dhonde Marg, Parel, Mumbai, MH 400012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7249-7955","authenticated-orcid":false,"given":"Dhruv","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology, Bai Jerbai Wadia Hospital for Children , Acharya Dhonde Marg, Parel, Mumbai, MH 400012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Shobhavat","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care Unit, Bai Jerbai Wadia Hospital for Children , Acharya Dhonde Marg, Parel, Mumbai, MH 400012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Hepatology, Bai Jerbai Wadia Hospital for Children , Acharya Dhonde Marg, Parel, Mumbai, MH 400012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026072710482131900_ref1","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/MPG.0000000000003268","article-title":"North American Society for Pediatric Gastroenterology, Hepatology, and nutrition position paper on the diagnosis and Management of Pediatric Acute Liver Failure","volume":"74","author":"Squires","year":"2022","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2026072710482131900_ref2","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1016\/j.toxrep.2023.04.010","article-title":"Disease-associated metabolic pathways affected by heavy metals and metalloid","volume":"10","author":"Haidar","year":"2023","journal-title":"Toxicol Rep"},{"key":"2026072710482131900_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.7733","article-title":"Severe arsenic poisoning due to Ayurvedic 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[Internet]","author":"Kumar","year":"2024"}],"container-title":["Oxford Medical Case 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