Drug-induced liver injury in pediatric age group: Single-center experience.

Background: There is no clear information regarding the frequency of drug-induced liver injury (DILI) in the pediatric age group. In this study, we aimed to investigate the incidence of DILI in pediatric patients and to determine the drug groups responsible for the etiology of DILI and the factors associated with this disease.

Methods: The prospective study was conducted in patients aged 0-18 years and diagnosed with DILI. Age, gender, drugs used by the patients, indications for drug use, duration and dosage of drugs, and laboratory parameters were recorded. Liver injury pattern was classified as hepatocellular, mixed and cholestatic type.

Results: The mean age was 7.8 ± 5.5 years; 187 (62.3%) were male. A total of 90 drugs were found to be responsible for hepatotoxicity, among which methotrexate (8.66%) and cephalosporin group antibiotics (8.66%) were found to be the most commonly identified drugs, followed by carbapenem group antibiotics (6.77%), steroids (6.77%) and mercaptopurine (5.04%). Hepatocellular type developed in 67% (n = 122), mixed type in 28% (n = 51) and cholestatic type in 5% (n = 8) patients.

Conclusions: Hepatocellular type was found to be the most common type among the patterns of liver injury in the pediatric age group. Although antibiotics constitute the leading cause of DILI, antibiotic choices are changing due to increasing resistant infections. The frequency of carbapenem-induced DILI is increasing.