N-acetylcysteine in children with acute liver failure complicating dengue viral infection

Objectives To describe the outcome after administration of N-acetylcysteine (NAC) to seven children with non-paracetamol induced acute liver failure (ALF) complicating dengue infection. Methods Clinical records of children with non paracetamol induced acute liver failure complicating severe dengue viral infection, were retrospectively analysed for clinical and biochemical outcome following treatment with NAC. Results Seven patients between ages six months to twelve years with plasma leakage and circulatory compromise complicating dengue infection developed ALF. Three were exposed to prolonged shock prior to hospitalisation. NAC infusion (100 mg/kg) was administered as soon as ALF was diagnosed, based on low GCS scores, raised transaminases and prolonged prothrombin/INR. Full clinical and biochemical recovery occurred in all patients. Conclusions A successful outcome followed early administration of NAC to children with ALF complicating severe dengue infection.