Acute liver failure after recommended doses of acetaminophen in patients with myopathies.
Acute liver failure after recommended doses of acetaminophen in patients with myopathies.
复制标题
肌病患者服用推荐剂量的对乙酰氨基酚后出现急性肝功能衰竭。
DOI：
10.1097/ccm.0b013e318206cc8f
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发表时间：
2011
影响因子：
8.8
通讯作者：
deWildt,SaskiaN
中科院分区：
文献类型：
--
作者：
Ceelie,Ilse;James,LauraP;Gijsen,Violette;Mathot,RonAA;Ito,Shinya;Tesselaar,CoranneD;Tibboel,Dick;Koren,Gideon;deWildt,SaskiaN
目的：确定推荐剂量的对乙酰氨基酚与肌病患者急性肝衰竭相关的可能性。设计：回顾性分析。设置：三级儿科重症监护病房。患者：两名肌病和急性肝衰竭的儿科患者。临床研究：我们确定对乙酰氨基酚蛋白加合物水平，结合文献综述和病例系统评价，使用药物性肝损伤的Escherosel Uclaf因果关系评估方法评估两名肌病儿童中推荐剂量的对乙酰氨基酚与急性肝衰竭之间的因果关系。主要结果：血清加合物水平与先前报告的对乙酰氨基酚过量后急性肝损伤儿童的值一致。我们在文献（n= 3）和个人交流（n= 1）中推荐的对乙酰氨基酚剂量后，在患有肌病的儿童和成人患者中发现了4例类似的急性肝功能衰竭病例。Uclaf因果关系评估方法建议对乙酰氨基酚的使用在推荐剂量和急性肝衰竭在我们的myopathy patients.Conclusion：我们的数据表明，一些患者与肌病谁正在接受推荐剂量的对乙酰氨基酚可能会增加风险的发展毒性导致急性肝衰竭。需要更多的研究来证实这些发现。与此同时，我们建议医生在这些患者服用对乙酰氨基酚时保持警惕，特别是在危重病或术后。
Objective:To determine the likelihood that recommended doses of acetaminophen are associated with acute liver failure in patients with myopathies.Design:Retrospective analysis.Setting:Level III pediatric intensive care unit.Patients:Two pediatric patients with myopathies and acute liver failure.Clinical Investigations:We determined acetaminophen protein adduct levels, in combination with a literature review and systematic evaluation of the cases, using the Roussel Uclaf Causality Assessment Method for drug-induced liver injury to assess causality between recommended acetaminophen dosing and acute liver failure in two children with myopathies.Main Results:The serum adduct levels were consistent with the values previously reported in children with acute liver injury following acetaminophen overdose. We found four similar cases of acute liver failure in pediatric and adult patients with myopathies following recommended acetaminophen doses in the literature (n= 3) and personal communication (n= 1). The Roussel Uclaf Causality Assessment Method suggested a probable relationship between acetaminophen use at recommended doses and acute liver failure in our myopathy patients.Conclusion:Our data suggest that some patients with myopathies who are receiving recommended doses of acetaminophen may be at increased risk for the development of toxicity resulting in acute liver failure. More studies are needed to corroborate these findings. In the meantime, we would advise physicians to be alert in these patients while taking acetaminophen, especially when critically ill or postoperative.