Acute liver failure in pediatric age, case report

Abstract

We present the clinical case of a 7-year-old pediatric patient who comes to the Emergency Service with a 15-day history of jaundice accompanied by vomiting, pain in the right hypochondrium, choluria, acholia, bringing with him results of laboratory tests performed. . previously where he reported neutrophilia without leukocytosis, altered liver function, total bilirubin 31, direct bilirubin 17.6, TGO 620, TGP 17, denied taking drugs or herbal products, no recent travel, physical examination showed considerable hepatomegaly, facing a presumptive diagnosis His admission of hyperbilirubinemia is complemented by tests such as prolonged coagulation times, alkaline phosphatase, GT range and high glucose, VDRL, HIV, TORCH, HEPATITIS B serology is added, being negative, it is complemented with an ultrasound study of the abdomen where the positive is hepato-splenomegaly. , acute reactive cholecystitis plus changes suggestive of inflammation of the pancreatic gland. Giving a twist to our diagnosis and changing it to severe liver failure, therapeutic support measures are given and transfer to third level health care is initiated for comprehensive management. Pediatric acute liver failure is characterized by the presence of liver damage, coagulopathy, jaundice and encephalopathy. In children it is rare, but with a fatal outcome in up to 70%. Diagnosis is based on liver function tests, in addition to percutaneous biopsy to determine the etiology. Treatment requires a multidisciplinary team that includes the hepatologist, intensive care specialist, and pediatric surgeon. There is no consensus about the indications for liver transplantation in ALF in pediatrics