A novel test can determine whether acetaminophen toxicity is involved

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Wednesday,

April 12, 2006

By

NEW YORK - In patients with acute liver failure, a novel test can

determine whether acetaminophen toxicity is involved, research suggests.

Dr. J. Davern II of the University

of California at San

Francisco

said; The test, which measures chemical byproducts of

acetaminophen that are released into the blood, is " both sensitive and

specific for acetaminophen toxicity.

Davern anticipates that this test, which is based on widely

available technology, will " aid in the clinical management of this

important problem. "

Acetaminophen (in painkillers

such as Tylenol) is present in more than 600 separate products and is generally

safe when used at up to the maximum daily doses recommended on package

labeling.

However, more than 56,000

emergency room visits and nearly 500 deaths in the US each year are attributed to acetaminophen toxicity, owing to

either intentional or unintentional overdoses. Acetaminophen toxicity is

currently the most common cause of acute liver failure in the US and Europe.

Although intentional

acetaminophen overdose is fairly easy to diagnose, in unintentional overdoses,

the diagnosis can be elusive, leading to a delay in the administration of

potentially life-saving treatment, Davern and

colleagues point out in the journal Gastroenterology.

In animal models, " serum

acetaminophen-protein adducts " or mutations, are specific biomarkers for

drug-related toxicity, and Davern's team has found

that the same is true in humans.

They examined serum samples

collected from 66 patients with acute liver failure. Of these, 20 were from

patients with well-characterized acetaminophen-related liver failure. Others

were from patients with other well-defined causes or with liver failure of

unknown origin.

Acetaminophen-protein adducts

were detected in all 20 of the patients with acetaminophen-related liver

failure. They were also seen in almost 7 of 36 indeterminate cases, suggesting

that acetaminophen might have been involved.

" The cases of cryptogenic

acute liver failure that previously had defied diagnosis were apparently caused

by occult acetaminophen toxicity, " Davern said.

" These results suggest that the problem of acetaminophen toxicity is even

greater than we had previously realized, " he said.

SOURCE: Gastroenterology March

2006.

Barb

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Ken (31) UC 91 - PSC 99