Acute liver failure (ALF) in children is rare, but when it happens, there is a fair probability that it was brought on by the use of drugs such as acetaminophen and antibiotics. Liver failure occurs when too many of the liver’s cells become damaged or die in a brief period of time. Because the condition progresses rapidly, immediate medical attention is needed to offset the larger damage in the body that liver failure can cause.
Of all prescription medications, antibiotics are the leading cause of liver failure in children. Drug-induced liver injury, whether caused by antibiotics or other types of prescription medicines and over-the-counter drugs, are more likely to occur in children older than 2 years.
Liver injury and acute liver failure are difficult to diagnose. According to the Cincinnati Children’s Hospital, “most of the time the cause of acute liver failure in children cannot be determined. One study showed that this was the case for about 44 percent of all children who were diagnosed with acute liver failure and about 63 percent for children with acute liver failure under 2 years of age.”
When the cause of liver failure is unknown, a liver transplant is the child’s only option. The greatest challenge posed by the transplant option, however, is that liver damage progresses very quickly while obtaining a donor liver for transplant usually takes a long time. This difficulty in treating ALF in children underscores the need to use certain medications sparingly and cautiously. Too much medicine too fast is one of the leading causes of drug-induced liver injury in children.
The symptoms of liver failure usually resemble a virus at first. The child is typically nauseated or vomiting and constantly fatigued. This condition progresses rapidly to jaundice and encephalopathy, a condition in which the brain fails to work properly and mental confusion sets in. Unfortunately, encephalopathy always occurs when the child experiences sudden and severe liver failure.
Signs of liver failure are less noticeable in infants 28 days old and younger. Babies older than 28 days may behave irritably, have inconsolable crying spells, or sleep more during the day than at night. Older children with liver failure often seem angry, forgetful or confused, have a hard time falling asleep, or feel constantly drowsy.
If a doctor knows with certainty that a child’s liver failure was drug-induced, the condition can sometimes be treated with medicine. If given early enough, medicinal treatments may reverse a drug-induced liver failure altogether.