Etiology of acute liver failure in children worldwide (final diagnosis as percent of cases in each region)

Etiology	North America and Europe*	Brazil	North Brazil	Argentina	Kolkata	North India	Hong Kong	Chile
Indeterminate	48	13	4	32	0	6	75	44
Viral hepatitis	6^¶
Hepatitis A		80	13	61	43	51		37
Hepatitis B		4	17	1	20	7
Hepatitis E					37	25
Hepatitis A/E						10
Hepatitis B/D			48
Hepatitis A/C		2
Hepatitis A/B			4
Hepatitis B/C			4
Autoimmune	7			2				11
Drugs	3			1			25	7
Wilson disease				1
Yellow fever			9
APAP	12
Metabolic	10
Other	11.8^Δ			1

Causes of acute liver failure in children worldwide, as percent of cases in each country or region. The most common causes in each region are shown in bold red font.

APAP: acetaminophen; PALFSG: Pediatric Acute Liver Failure Study Group.
* Data from the PALFSG, from 2000 to 2007.
¶ For the PALFSG data, this category includes all viral causes of acute liver failure. In this population, herpes simplex virus was the most common viral cause of acute liver failure in infants; Epstein-Barr virus and hepatitis A virus were the most common viral causes in older children.
Δ For the PALFSG data, the "other" category includes shock/ischemia, gestational alloimmune liver disease (neonatal hemochromatosis), veno-occlusive disease, hemophagocytic syndrome, Budd-Chiari, and "other diagnosis."

Modified with permission from: Squires RH, Alonso EM. Acute liver failure in children. In: Liver Disease in Children, 4th ed, Suchy FJ, Sokol RJ, Balistreri WF (Eds), Cambridge University Press, New York 2012. Copyright © 2012 Cambridge University Press.

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Etiology of acute liver failure in children worldwide (final diagnosis as percent of cases in each region)