Bio: Dr. Lai is a physician-scientist specializing in hepatology and infectious diseases, with a focus on drug induced liver injury (DILI), Metabolic-dysfunction-associated fatty liver disease (MAFLD), and chronic viral hepatitis. She earned her MD and PhD from Shanghai Jiaotong University School of Medicine, where she conducted groundbreaking research on the role of Th22 cells and IL-22 in drug induced hepatocellular injury, published in Journal of Hepatology (impact factor: 26.8). Dr. Lai completed her clinical training at Ruijin Hospital and served as a Visiting Scholar at Stanford University Medical Center, where she advanced her expertise in risk stratification and precision medicine for MAFLD. As Deputy Chief of hepatology & infectious diseases at Ruijin Hospital, Dr. Lai leads clinical and research efforts in managing complex liver diseases, including DILI, NAFLD, chronic hepatitis B and C, and liver failure. Her work has been published in high-impact journals such as PLoS Medicine, JHEP Reports, and Clinical Gastroenterology and Hepatology.

Abstract: Limited data on the clinical profile of drug induced liver injury (DILI) in Chinese children. We aimed to assess the clinical profile, suspected drugs, and outcomes of pediatric DILI in China. This nationwide, multicenter, retrospective study (2012-2014) analyzed 25,927 suspected DILI cases from 308 medical centers. Utilizing the Roussel Uclaf causality assessment method score, only patients with scores ≥6 or diagnosed with DILI by three experts after scoring <6 were included in the analysis. Among them, 460 cases met the EASL biochemical criteria. Hepatocellular injury was the predominant clinical classification, accounting for 63% of cases, with 34% of these cases meeting Hy's law criteria. Adolescents (12 to <18 years old) comprised the majority of children with moderate/severe DILI (65%). Similarly, adolescents faced a significantly higher risk of severe liver injury compared to younger children (adjusted odd ratios 4.75, p = 0.002). The top three most frequently prescribed drug classes across all age groups were antineoplastic agents (25.9%), antimicrobials (21.5%), and traditional Chinese medicine (13.7%). Adolescents are at a greater risk of severe and potentially fatal liver injury compared to younger children. Recognizing the risk of pediatric DILI is crucial for ensuring safe medical practices.