PMID- 21098156
OWN - NLM
STAT- MEDLINE
DCOM- 20110208
LR  - 20181201
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 126
IP  - 6
DP  - 2010 Dec
TI  - Therapeutic acetaminophen is not associated with liver injury in children: a 
      systematic review.
PG  - e1430-44
LID - 10.1542/peds.2009-3352 [doi]
AB  - BACKGROUND: Concern exists about the potential for liver injury with therapeutic 
      dosing of acetaminophen in children. OBJECTIVE: We systematically reviewed the 
      medical literature to determine the rate at which liver injury has been reported 
      for children prescribed therapeutic doses of acetaminophen (</=75 mg/kg per day 
      orally or intravenously or </=100 mg/kg per day rectally). METHODS: We searched 
      Medline, Embase, and the Cochrane Central Register of Controlled Trials to locate 
      all studies in which acetaminophen was administered to a defined pediatric 
      population for >/=24 hours and for all case reports of liver injury after 
      therapeutic acetaminophen dosing. Trained reviewers extracted data from each 
      report. Major and minor hepatic adverse events (AEs) were defined prospectively. 
      Causality was assessed by using the Naranjo algorithm. RESULTS: A total of 62 
      studies that enrolled 32,414 children were included. No child (0% [95% confidence 
      interval: 0.000-0.009]) was reported to have exhibited signs or symptoms of liver 
      disease, to have received an antidote or transplantation, or to have died. Major 
      or minor hepatic AEs were reported for 10 children (0.031% [95% confidence 
      interval: 0.015-0.057]). The highest transaminase value reported was 600 IU/L. 
      Naranjo scores (2-3) suggested "possible" causation. Twenty-two case reports were 
      identified. In 9 cases, the Naranjo score suggested "probable" causation (5-6). 
      CONCLUSIONS: Hepatoxicity after therapeutic dosing of acetaminophen in children 
      is rarely reported in defined-population studies. Case reports suggest that this 
      phenomenon may occur, but few reports contain sufficient data to support a 
      probable causal relationship.
FAU - Lavonas, Eric J
AU  - Lavonas EJ
AD  - Rocky Mountain Poison & Drug Center, 777 Bannock St, MC 0180, Denver, CO 80204, 
      USA. eric.lavonas@rmpdc.org
FAU - Reynolds, Kate M
AU  - Reynolds KM
FAU - Dart, Richard C
AU  - Dart RC
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20101122
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Analgesics, Non-Narcotic)
RN  - 362O9ITL9D (Acetaminophen)
SB  - IM
MH  - Acetaminophen/*administration & dosage
MH  - Administration, Oral
MH  - Analgesics, Non-Narcotic/*administration & dosage
MH  - Child
MH  - Dose-Response Relationship, Drug
MH  - Drug-Related Side Effects and Adverse Reactions
MH  - Humans
MH  - Liver/*drug effects
MH  - Liver Failure/diagnosis/*etiology
MH  - Liver Function Tests
EDAT- 2010/11/26 06:00
MHDA- 2011/02/09 06:00
CRDT- 2010/11/25 06:00
PHST- 2010/11/25 06:00 [entrez]
PHST- 2010/11/26 06:00 [pubmed]
PHST- 2011/02/09 06:00 [medline]
AID - peds.2009-3352 [pii]
AID - 10.1542/peds.2009-3352 [doi]
PST - ppublish
SO  - Pediatrics. 2010 Dec;126(6):e1430-44. doi: 10.1542/peds.2009-3352. Epub 2010 Nov 
      22.