LIVER DAMAGE AFTER PARACETAMOL OVERDOSE COMPARISON OF LIVER-FUNCTION TESTS, FASTING SERUM BILE ACIDS, AND LIVER HISTOLOGY
1975; Elsevier BV; Volume: 306; Issue: 7935 Linguagem: Inglês
10.1016/s0140-6736(75)90170-1
ISSN1474-547X
AutoresOliver James, Susan H. Roberts, A S Douglas, M Lesna, L. Pulman, Pam Smith, Alexander Watson,
Tópico(s)Liver Disease and Transplantation
Resumo54 patients have been studied after paracetamol (acetaminophen) overdose. Liver-function tests and fasting serum bile-acids were measured daily; liver biopsy was done in all cases, and slides were examined "blind" to assess liver damage. The plasma-paracetamol was measured on one occasion. A histological abnormality was present in the livers of 53 of the 54 patients, and was minor in 23, moderate in 16, and severe in 14. In 6 patients with moderate and 18 with mild histological abnormality liver-function tests were normal. A serum-aspartate-aminotransferase above 400 units/1 was always associated with severe histological liver damage. Fasting serum bile-acids were raised in 51 of the patients with abnormal liver histology; the serum-bileacid seemed to be a more sensitive indicator of mild liver-cell damage than was the transaminase level. There was, however, little correlation between increase in bile-acid concentration and the degree of histological abnormality. As a result of these investigations empirically determined levels of plasma-paracetamol have been drawn which give a guide to the likelihood of liver damage after paracetamol overdose.
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