Journal article
Detection of Acetaminophen Protein Adducts in Children With Acute Liver Failure of Indeterminate Cause
Pediatrics (Evanston), v 118(3), pp e676-e681
01 Sep 2006
PMID: 16950959
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE. Acetaminophen cysteine protein adducts are a widely recognized correlate of acetaminophen-mediated hepatic injury in laboratory animals. The objective of this study was to use a new assay for the detection of acetaminophen cysteine protein adducts in children with acute liver failure to determine the role of acetaminophen toxicity in acute liver failure of unknown cause.
METHODS. Serum samples from children with acute liver failure were measured for acetaminophen cysteine protein adducts using high-performance liquid chromatography with electrochemical detection. For comparison, samples from children with well-characterized acetaminophen toxicity and children with known other causes of acute liver failure also were measured for acetaminophen cysteine protein adducts. The analytical laboratory was blinded to patient diagnoses.
RESULTS. Acetaminophen cysteine protein adduct was detected in 90% of samples from children with acute liver failure that was attributed to acetaminophen toxicity, 12.5% of samples from children with acute liver failure of indeterminate cause, and 9.6% of samples from children with acute liver failure that was attributed to other causes. Adduct-positive patients from the indeterminate cause subgroup had higher levels of serum aspartate aminotransferase and alanine aminotransferase and lower levels of bilirubin. Adduct-positive patients also had lower rates of transplantation and higher rates of spontaneous remission.
CONCLUSIONS. A small but significant percentage of children with acute liver failure of indeterminate cause tested positive for acetaminophen cysteine protein adducts, strongly suggesting acetaminophen toxicity as the cause of acute liver failure. An assay for the detection of acetaminophen cysteine protein adducts can aid the diagnosis of acetaminophen-related liver injury in children.
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Details
- Title
- Detection of Acetaminophen Protein Adducts in Children With Acute Liver Failure of Indeterminate Cause
- Creators
- Laura P. James - University of Arkansas for Medical SciencesEstella M. Alonso - Northwestern UniversityLinda S. Hynan - The University of Texas Southwestern Medical CenterJack A. Hinson - University of Arkansas for Medical SciencesTimothy J. Davern - University of California, San FranciscoWilliam M. Lee - The University of Texas Southwestern Medical CenterRobert H. Squires - University of Pittsburghthe Pediatric Acute Liver Failure Study GroupAshish Dhawan - Pediatrics
- Publication Details
- Pediatrics (Evanston), v 118(3), pp e676-e681
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000240959100093
- Scopus ID
- 2-s2.0-33749067030
- Other Identifier
- 991019173456304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics