Hepatotoxicity after paracetamol overdose in a patient with cystic fibrosis despite early acetylcysteine and utility of microRNA to predict hepatotoxicity.
Clin Toxicol (Phila)
; 56(10): 904-906, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-29564929
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Acetilcisteína
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Fibrose Cística
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MicroRNAs
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Doença Hepática Induzida por Substâncias e Drogas
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Overdose de Drogas
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Acetaminofen
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Antídotos
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article