Pediatric viral hepatitis: Avoiding liver failure

Norberto Sotelo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Acute liver failure (ALF) is defined as a multisystem disorder of severe impairment of liver function, with or without encephalopathy, which is associated with hepatocellular necrosis (reflected as liver synthetic failure in patients with no recognized chronic liver disease), and can lead to death. ALF can be due to hepatotoxic drugs, natural toxins, autoimmune disease, severe bacterial infection and some neoplastic processes, or ALF can be idiopathic. In the pediatric group, the most frequent cause is viral agents; hepatitis A is the most common among these. The pathophysiologic changes in ALF consist of alterations in coagulation, elevated serum ammonia, hypoalbuminemia and hypoglycemia. In recent years, N-acetylcysteine has been utilized to treat this condition. Using this drug during the early stages of the disease has the potential to improve outcomes for the patient, including the avoidance liver transplantation. This article focuses on the criteria that help to identify ALF and emphasizes accessible alternative medical treatments.

Original languageEnglish
Pages (from-to)613-622
Number of pages10
JournalPediatric Health
Issue number6
StatePublished - Dec 2010
Externally publishedYes


  • acetylcisteine
  • encephalopathy
  • liver failure
  • viral hepatitis


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