A systematic review on the effectiveness of N-acetylcysteine in children with dengue-associated liver injury
- Author:
DJ G. Leaño
;
Meadina G. Cruz
- Publication Type:Journal Article
- Keywords:
Dengue Associated Liver Injury;
Dengue Hepatitis
- MeSH:
Acetylcysteine
- From:
The Philippine Children’s Medical Center Journal
2024;20(1):46-58
- CountryPhilippines
- Language:English
-
Abstract:
Objectives:This study aimed to determine the effectiveness of N-acetylcysteine (NAC) in reversal of liver enzyme abnormalities among pediatric patients with dengue induced liver injury.
Materials and Methods:The preferred reporting items for systematic review and
meta-analysis protocols (PRISMA-P 2020) declaration was used to create this systematic review.
The study population included children (<18 years old) diagnosed with dengue-associated Liver
Injury and given NAC. The outcome of interest was full recovery. A search was performed in
PubMed/MEDLINE, EMBASE, Google Scholar, HERDIN PLUS, WPRIM, clinicaltrials.gov, and
Cochrane databases on March 2023. The New Castle-Ottawa Quality Assessment Scale was
adapted for risk of bias assessment for cohort studies.
Results:Three case series and one pre-post cohort study published from 2013 to 2022 were
included. The studies were of acceptable quality. In two studies with overall 10 pediatric patients
given NAC for dengue-related ALF, all recovered without adverse events. In one study with 4
patients given NAC, half survived with their liver function tests returning to normal values.
Finally, in one comparative study, the durations of time before the liver function tests returned to
normal levels, and the mortality rates between those treated with and without N-acetyl cysteine
were not significantly different. All studies reported no occurrence of adverse drug reaction related
to NAC.
Conclusion:This systematic review shows limited evidence on the effectiveness of NAC in
the reversal of liver enzymes among pediatric patients because of the low incidence of dengue
induced liver injury seen in observational studies. Given that NAC is reported by all four studies to
be accessible, effective, and with no attributable adverse events, its use can be considered.
However, clinicians must still be cautioned given the limited available evidence.
- Full text:2024062614315265043A systematic review on the effectiveness.pdf
