False positive acetaminophen concentrations in patients with liver injury.

@article{Polson2008FalsePA,
  title={False positive acetaminophen concentrations in patients with liver injury.},
  author={J. Polson and F. Wians and P. Orsulak and D. Fuller and N. Murray and J. Koff and Adil I. Khan and J. Balko and L. Hynan and William M. Lee},
  journal={Clinica chimica acta; international journal of clinical chemistry},
  year={2008},
  volume={391 1-2},
  pages={
          24-30
        }
}
BACKGROUND Acetaminophen toxicity is the most common form of acute liver failure in the U.S. After acetaminophen overdoses, quantitation of plasma acetaminophen can aid in predicting severity of injury. However, recent case reports have suggested that acetaminophen concentrations may be falsely increased in the presence of hyperbilirubinemia. METHODS We tested sera obtained from 43 patients with acute liver failure, mostly unrelated to acetaminophen, utilizing 6 different acetaminophen… Expand

Paper Mentions

Observational Clinical Trial
The purpose of this study is to collect clinical and epidemiological data as well as serum, plasma, urine, tissue and DNA samples on individuals who have acute liver failure and on… Expand
ConditionsAcute Liver Failure, Acute Liver Injury, Fulminant Hepatic Failure
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References

SHOWING 1-8 OF 8 REFERENCES
False Positive Acetaminophen Levels Associated with Hyperbilirubinemia
TLDR
Caution must be taken utilizing the GDS Diagnostic assay for the quantification of acetaminophen with concomitant hyperbilirubinemia, and alternatives such as EMIT or GC/MS should be employed to assess acetamophen levels in such patients. Expand
Measurement of serum acetaminophen-protein adducts in patients with acute liver failure.
TLDR
Measurement of serumacetaminophen-protein adducts reliably identified acetaminophen toxicity, and may be a useful diagnostic test for cases lacking historical data or other clinical information. Expand
False-positive acetaminophen results in a hyperbilirubinemic patient.
TLDR
The data are consistent with bilirubin interference in the enzymatic and/or chromogenic reactions involved in the acetaminophen method. Expand
Acetaminophen‐induced acute liver failure: Results of a United States multicenter, prospective study
TLDR
In conclusion, acetaminophen hepatotoxicity far exceeds other causes of acute liver failure in the United States, and education of patients, physicians, and pharmacies to limit high‐risk use settings is recommended. Expand
Acetaminophen poisoning and toxicity.
TLDR
Although toxicity and fatalities have occurred in the adolescent age group, only one death in younger children has been recorded and the question must be raised as to how many cases of "jaundice of unknown etiology" are actually due to this drug. Expand
Results of a Prospective Study of Acute Liver Failure at 17 Tertiary Care Centers in the United States
TLDR
The primary aim was to compare presenting clinical features and liver transplantation in patients with acute liver failure related to acetaminophen hepatotoxicity, other drugs, indeterminate factors, and other causes. Expand
Mechanisms of Acetaminophen-Induced Hepatotoxicity: Role of Oxidative Stress and Mitochondrial Permeability Transition in Freshly Isolated Mouse Hepatocytes
TLDR
Data from mouse hepatocytes used to determine the role of mitochondrial permeability transition (MPT) in acetaminophen (APAP) toxicity are consistent with a hypothesis where APAP-induced cell death occurs by two phases, a metabolic phase and an oxidative phase. Expand
Analysis of the optical properties of bile.
TLDR
The analysis of pH dependence evidenced the presence of different calibration curves at different pH values: the self-aggregation of the bilirubin molecules observed in pure bile samples was almost totally absent in the gastric samples. Expand