Clinical Course among Cases of Acute Liver Failure of Indeterminate Diagnosis

The Journal of Pediatrics
Ruosha LiPediatric Acute Liver Failure Study Group

Abstract

To investigate the heterogeneity in clinical course among those with pediatric acute liver failure (PALF) of indeterminate disease etiology. We studied participants enrolled in the PALF registry study with indeterminate final diagnosis. Growth mixture modeling was used to analyze participants' international normalized ratio, total bilirubin, and hepatic encephalopathy trajectories in the first 7 days following enrollment. Participants with at least 3 values for 1 or more of the measurements were included. We examined the association between the resulting latent subgroup classification with participants' characteristics and disease outcomes. Data from participants with PALF of specified etiologies were used to investigate the potential diagnostic value of the latent subgroups. In this sample of 380 participants with indeterminate final diagnosis, 115 (30%) experienced mild and quickly improving disease trajectories and another 48 (13%) started with severe disease but improved by day 7. The majority of participants (216, 57%) had disease trajectories that worsened over time. The identified patterns of disease trajectories are predictive of outcome (P < .001). The trajectory patterns are associated with the underlying disease etio...Continue Reading

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Citations

Apr 1, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Catherine A ChapinEstella M Alonso
Aug 3, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·James E SquiresRobert H Squires
May 23, 2020·Journal of Pediatric Gastroenterology and Nutrition·Eun Joo LeeJae Sung Ko
Sep 28, 2017·Italian Journal of Pediatrics·Pier Luigi CalvoMarco Spada
Apr 16, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Mike A LeonisUNKNOWN Pediatric Acute Liver Failure Study Group
Aug 17, 2020·Journal of Pediatric Gastroenterology and Nutrition·Catherine A ChapinUNKNOWN Pediatric Acute Liver Failure Study Group
Feb 17, 2019·The Journal of Pediatrics·Catherine A ChapinEstella M Alonso
May 4, 2018·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Michael R NarkewiczUNKNOWN Pediatric Acute Liver Failure Study Group

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