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Órgano Oficial de la Asociación Mexicana de Hepatología
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2011, Number 2

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Ann Hepatol 2011; 10 (2)

Elevated acetaminophen level: Could it be a red herring?

Dale C, Denesyk KL, Chandok N
Full text How to cite this article

Language: English
References: 5
Page: 239-240
PDF size: 24.12 Kb.


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Dear Editor:
A 34 year old woman, previously healthy and on no medications or supplements, presented with a 5 week history of fatigue and jaundice. She denied alcohol or illicit drug use. She had no encephalopathy or ascites, and transaminases were 8 times normal, gamma-glutamyl transpeptidase 9 times normal, alkaline phosphatase 3 times normal, INR 1.7 (normal 0.9-1.1), MCV 97 fL (normal 80-98 fL) and bilirubin and conjugated bilirubin both above upper limit of detection (570 and 180 umol/L, respectively; normal 3.4-17.1 and ‹ 5.1 umol/L, respectively).


REFERENCES

  1. Smilkstein MJ, Knapp GL, Kulig KW, Rumack BH. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985). N Engl J Med 1988; 319(24): 1557-62.

  2. Diagnostics R. Acetaminophen cobas. Indianapolis. In: Roche Diagnostics; 2009, p. 1-3.

  3. Polson J, Wians FHJr, Orsulak P, Fuller D, Murray NG, Koff JM, et al. False positive acetaminophen concentrations in patients with liver injury. Clin Chim Acta 2008; 391(1-2): 24-30.

  4. Beuhler MC, Curry SC. False positive acetaminophen levels associated with hyperbilirubinemia. Clin Toxicol (Phila) 2005; 43(3): 167-70.

  5. Brooks KE, Smith NB. Versatile, efficient system for extracting drugs from urine for gas chromatographic/mass spectrometric analysis. Clin Chem 1989; 35(10): 2100-3.




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C?MO CITAR (Vancouver)

Ann Hepatol. 2011;10