1 - Área de Pediatria Médica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2 - Unidade de Infecciologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
3 - Unidade de Gastrenterologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
4 - Unidade de Neuropediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Artigo publicado em versão integral (Journal of Pediatric Gastroenterology and Nutrition Reports)
Drug-induced liver injury (DILI) is a frequent complication of most drug regimens, having replaced viral hepatitis as the most com- mon cause of liver failure in adults (1). Known risk factors include use of other hepatotoxic drugs, preexisting liver disease, hepatotropic infections, younger age, and extrapulmonary tuberculosis (TB) (1).
The ketogenic diet (KD) as an antiepileptic therapy is based on the induction of ketosis resulting from free fatty acid β-oxidation, in a protein and carbohydrate restriction context (2). Although uncom- mon, KD has been linked to liver injury, especially when other poten- tially hepatotoxic drugs are used simultaneously (3). The precise mechanism through which toxicity occurs has not yet been clarified.
We report 2 cases depicting a rare situation that, to the best of our knowledge, hasn’t been described before, aiming to highlight the difficulty of determining specific causes of hepatotoxicity in complex patients receiving multiple drug regimens or diets.
Palavras Chave: ketogenic diet; tuberculosis; hepatoxicity; epilepsy