Original articleAcute liver failure in children: The first 348 patients in the pediatric acute liver failure study group
Section snippets
Organization
The PALF study group began as an adjunct to the National Institutes of Health–sponsored, adult-focused ALF Study Group (William Lee, MD, Principal Investigator). The PALF study group now consists of 24 active pediatric sites, 21 within the United States, 1 in Canada, and 2 in the United Kingdom. Working groups of pediatric hepatologists established definitions for ALF and various diagnostic categories. Representatives from all participating centers approved final recommendations from the
Results
Between December 1999 and December 2004, 348 children were enrolled; patient demographics are outlined in Table II. The median dose of acetaminophen ingested was 183 mg/kg (range 19.2 to 734.1). There was an association between cause and sex (P = .0002), with the percentage of females significantly higher in the acetaminophen group compared with both non-acetaminophen groups (TTMC P < .05, 79% vs 46% or vs 60%, respectively). The association between the three etiologic categories and race
Discussion
This report of the first 348 children in the PALF data set highlights a number of important observations: (1) HE is not an absolute requirement to establish the diagnosis of ALF in children; (2) a specific diagnosis was not made in almost half of all infants and children; (3) the causes of ALF in children differ from those seen in adults,16 with children having more indeterminate cases and fewer acetaminophen and viral-induced cases; and (4) short-term outcome varied among diagnostic groups.
HE
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Supported by NIH grant RO1-DK58369-01; and by M01-RR00069, M01-RR00037, and M01 RR08084 from the General Clinical Research Center Program of the National Center for Research Resources of the NIH.