Abstract
Case details: A 19-year-old girl presented to the emergency department following overdose of 10 g of paracetamol on a background history of cystic fibrosis. Paracetamol concentration was below the nomogram line, but was treated with acetylcysteine seven hours post-overdose given her symptomatology. Nineteen hours following her overdose she developed hepatotoxicity, despite early initiation of acetylcysteine. She was discharged well six days post-ingestion. On presentation, delta miRNA-122-miR483 was 20 times that of control patients, however, alanine aminotransferase was normal. Discussion: Patients with cystic fibrosis are more likely to have glutathione deficiency, and greater susceptibility to liver injury. Delta miRNA may be a better detector of early liver injury than hepatic aminotransferases. Empiric treatment with acetylcysteine and serial biochemical reassessment in this setting should be considered.
| Original language | English |
|---|---|
| Pages (from-to) | 904–906 |
| Number of pages | 3 |
| Journal | Clinical Toxicology |
| Volume | 56 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 3 Oct 2018 |
Keywords
- Acetaminophen
- liver injury
- nomogram
- risk assessment
Cite this
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Hepatotoxicity after paracetamol overdose in a patient with cystic fibrosis despite early acetylcysteine and utility of microRNA to predict hepatotoxicity. / Wong, Anselm; Cheung, Benjamin; Nejad, Charlotte; Gantier, Michael; Graudins, Andis.
In: Clinical Toxicology, Vol. 56, No. 10, 03.10.2018, p. 904–906.Research output: Contribution to journal › Article › Other › peer-review
TY - JOUR
T1 - Hepatotoxicity after paracetamol overdose in a patient with cystic fibrosis despite early acetylcysteine and utility of microRNA to predict hepatotoxicity
AU - Wong, Anselm
AU - Cheung, Benjamin
AU - Nejad, Charlotte
AU - Gantier, Michael
AU - Graudins, Andis
PY - 2018/10/3
Y1 - 2018/10/3
N2 - Case details: A 19-year-old girl presented to the emergency department following overdose of 10 g of paracetamol on a background history of cystic fibrosis. Paracetamol concentration was below the nomogram line, but was treated with acetylcysteine seven hours post-overdose given her symptomatology. Nineteen hours following her overdose she developed hepatotoxicity, despite early initiation of acetylcysteine. She was discharged well six days post-ingestion. On presentation, delta miRNA-122-miR483 was 20 times that of control patients, however, alanine aminotransferase was normal. Discussion: Patients with cystic fibrosis are more likely to have glutathione deficiency, and greater susceptibility to liver injury. Delta miRNA may be a better detector of early liver injury than hepatic aminotransferases. Empiric treatment with acetylcysteine and serial biochemical reassessment in this setting should be considered.
AB - Case details: A 19-year-old girl presented to the emergency department following overdose of 10 g of paracetamol on a background history of cystic fibrosis. Paracetamol concentration was below the nomogram line, but was treated with acetylcysteine seven hours post-overdose given her symptomatology. Nineteen hours following her overdose she developed hepatotoxicity, despite early initiation of acetylcysteine. She was discharged well six days post-ingestion. On presentation, delta miRNA-122-miR483 was 20 times that of control patients, however, alanine aminotransferase was normal. Discussion: Patients with cystic fibrosis are more likely to have glutathione deficiency, and greater susceptibility to liver injury. Delta miRNA may be a better detector of early liver injury than hepatic aminotransferases. Empiric treatment with acetylcysteine and serial biochemical reassessment in this setting should be considered.
KW - Acetaminophen
KW - liver injury
KW - nomogram
KW - risk assessment
UR - http://www.scopus.com/inward/record.url?scp=85044337631&partnerID=8YFLogxK
U2 - 10.1080/15563650.2018.1454596
DO - 10.1080/15563650.2018.1454596
M3 - Article
VL - 56
SP - 904
EP - 906
JO - Clinical Toxicology
JF - Clinical Toxicology
SN - 1556-3650
IS - 10
ER -