Table 3. Etiology of PALF in children 0-22 years old in developed and developing countries.
| Etiology* | Developed (n=2,019) | Mean | 95% credible interval | Etiology† | Developing (n=970) | Mean | 95% credible interval | ||
|---|---|---|---|---|---|---|---|---|---|
| Lower | Upper | Lower | Upper | ||||||
| Indeterminate | 770 | 39.7 | 37.6 | 41.9 | Hepatitis A | 316 | 28.9 | 26.3 | 31.7 |
| Acetaminophen toxicity | 179 | 9.24 | 7.99 | 10.6 | Indeterminate | 220 | 20.1 | 17.8 | 22.6 |
| Unspecified metabolic disorder | 106 | 5.47 | 4.5 | 6.52 | Unspecified infection | 104 | 9.52 | 7.86 | 11.3 |
| Unspecified infection | 98 | 5.06 | 4.13 | 6.08 | Wilson's disease | 85 | 7.78 | 6.27 | 9.44 |
| Other | 79 | 4.08 | 3.24 | 5 | Autoimmune disorder | 48 | 4.4 | 3.26 | 5.69 |
| Ischemia | 67 | 3.46 | 2.69 | 4.31 | Unspecified toxin | 30 | 2.75 | 1.86 | 3.8 |
| Unspecified toxin | 64 | 3.3 | 2.55 | 4.14 | Dengue virus | 29 | 2.66 | 1.79 | 3.69 |
| Hemophagocytic lymphohistiocytosis | 55 | 2.84 | 2.15 | 3.62 | Unspecified metabolic disorder | 29 | 2.66 | 1.79 | 3.69 |
| Herpes simplex virus+enterovirus co-infection | 53 | 2.73 | 2.06 | 3.51 | Hemophagocytic lymphohistiocytosis | 28 | 2.56 | 1.71 | 3.58 |
| Wilson's disease | 51 | 2.63 | 1.97 | 3.39 | Acetaminophen toxicity | 27 | 2.47 | 1.64 | 3.47 |
| Congenital heart disease | 43 | 2.22 | 1.61 | 2.92 | Mushroom toxicity | 19 | 1.74 | 1.05 | 2.6 |
| Galactosemia | 39 | 2.01 | 1.44 | 2.68 | Hepatitis B | 11 | 1.01 | 0.504 | 1.68 |
| Hemochromatosis | 31 | 1.6 | 1.09 | 2.2 | Galactosemia | 11 | 1.01 | 0.504 | 1.68 |
| Autoimmune disorder | 30 | 1.55 | 1.05 | 2.14 | Albendazole toxicity | 11 | 1.01 | 0.504 | 1.98 |
| Non-A-B-C hepatitis | 23 | 1.19 | 0.754 | 1.71 | |||||
| Herpes simplex virus | 23 | 1.19 | 0.754 | 1.71 | |||||
| Unspecified mitochondrial disorder | 21 | 1.08 | 0.672 | 1.59 | |||||
PALF: pediatric acute liver failure.
*Etiologies of PALF in developed countries that accounted for less than 1% of diagnoses include: Hepatitis A, Myelodysplastic syndrome, Mushroom toxicity, Mitochondrial respiratory deficiency, Ornithine transcarboxylase deficiency, Respiratory failure, Hypoxia, Fetal distress, Enterovirus, Autoimmune hepatitis type 1 & 2, Leukemia, Tyrosinemia type I, Hematologic/oncologic cause, Hepatitis E, Solid tumor, Gastrointestinal anomaly, Adenovirus, Veno-occlusive disease, Congenital diaphragmatic hernia, Hepatitis B, Parvovirus B19, Influenza, Defect in glycosylation, Niemann pick C, Human herpes virus 6, Hyperornithinemia-hyperammonemia-homocitrullinemia syndrome, Isoniazid toxicity, Lamotrigine toxicity, Gestational alloimmune disease, Chemotherapy, Hodgkins lymphoma, Recurrent acute liver failure.
†Etiologies of PALF in developing countries that accounted for less than 1% of diagnoses include: Non A-G Hep, Cytomegalovirus, Epstein-barr virus, Tyrosinemia 1, Ischemia/hypoxia hemochromatosis, Autoimmune hepatitis type 1 & 2, Sepsis, Fatty acid oxidation defect, Hepatitis E, Herpes simplex virus, Fructose intolerance, Carnitine palmitoyltransferase 1 deficiency, Isoniazid toxicity, Phosphorous ingestion, Mitochondrial disorder, Hepatitis A virus+Hepatitis E virus coinfection, Varicella zoster virus, Urea cycle defect, Reyes syndrome, Firework toxicity, Lymphoma, Cardiomyopathy, Congenital hypopituitarism.