scholarly journals A case of acute liver failure with hepatic coma after administration of high-dose acetaminophen

Kanzo ◽  
2018 ◽  
Vol 59 (7) ◽  
pp. 363-369 ◽  
Author(s):  
Akitoshi Yoneda ◽  
Masaaki Hiura ◽  
Tsukasa Karasuyama ◽  
Yuichi Honma ◽  
Michihiko Shibata ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatic Coma ◽  
High Dose

scholarly journals The Effects of High-Dose Qinggan Huoxue Recipe on Acute Liver Failure Induced by D-Galactosamine in Rats

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Hong Zhu ◽  
Yang Zhang ◽  
Xiaoyu Hu ◽  
Cheng Yi ◽  
Sen Zhong ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Survival Curve ◽  
Survival Rates ◽  
High Mobility ◽  
Nuclear Antigen ◽  
High Dose ◽  
Improve Liver Function ◽  
Proliferating Cell

Qinggan Huoxue Recipe is a traditional Chinese medicine, which has been usually used to improve liver function in hepatitis. In order to investigate the effects of high-dose Qinggan Huoxue Recipe on acute liver failure and explore the potential mechanism, we had built acute liver failure models in rats by intraperitoneal injection of D-galactosamine (D-GalN). High-dose Qinggan Huoxue Recipe was delivered by gavage. After treatment, the blood alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), cholinesterase (CHE), and prothrombin time (PT) were determined. The pathological score of liver tissue was recorded. Proliferating cell nuclear antigen (PCNA) immunohistochemistry staining and fluorescence quantitative reverse transcription polymerase chain reaction (qRT-PCR) of high mobility group box 1 (HMGB1), toll-like receptor 4 (TLR4), nuclear factor-kappa B (NF-κB), and Caspase-3 were performed. The survival curve was also depicted. Our results demonstrated that high-dose Qinggan Huoxue Recipe could significantly improve liver function and increase survival rates in rats with acute liver failure. These effects were supposed to be mediated by suppressing inflammatory reaction and apoptosis.

Possible Hepatotoxicity Associated With Daptomycin

2016 ◽  
Vol 29 (3) ◽  
pp. 253-256 ◽  
Author(s):  
Yoonsun Mo ◽  
Fletcher Nehring ◽  
Andrew H. Jung ◽  
Seth T. Housman
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Pain Syndrome ◽  
Liver Function Tests ◽  
Future Research ◽  
High Dose ◽  
History Of ◽  
The Relationship

Purpose To report a case of isolated daptomycin-induced acute liver injury without elevations in creatine kinase (CK) levels or kidney dysfunction. Summary A 49-year-old female with a history of pancreatitis, lupus, diabetes, congestive heart failure, hypertension, and chronic pain syndrome presented to the emergency department with alteration in mental status and acute liver failure. The patient had been treated with daptomycin for methicillin-resistant Staphylococcus aureus (MRSA) endocarditis for 3 weeks. After ruling out other possible etiologies, daptomycin was suspected as a cause of acute liver failure. Her liver failure resolved gradually following withdrawal of daptomycin. Conclusion Although hepatic abnormalities caused by daptomycin are rare, a handful of cases with daptomycin-induced liver injury have been reported in the literature. Of note, in most cases, patients on daptomycin therapy developed liver damage with elevations in CK levels. Our case report suggests possible severe liver injury associated with high-dose and long-term daptomycin treatment in the absence of rhabdomyolysis. Future research is warranted to further investigate the relationship between daptomycin use and liver injury, yet it is reasonable to monitor liver function tests at baseline and weekly thereafter along with CK levels, especially in patients requiring long-term daptomycin therapy.

scholarly journals SIRS Score Reflects Clinical Features of Non-Acetaminophen-Related Acute Liver Failure with Hepatic Coma

2012 ◽  
Vol 51 (8) ◽  
pp. 823-828 ◽  
Author(s):  
Yasuhiro Miyake ◽  
Tetsuya Yasunaka ◽  
Fusao Ikeda ◽  
Akinobu Takaki ◽  
Kazuhiro Nouso ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Clinical Features ◽  
Hepatic Coma

scholarly journals Acute liver failure following paracetamol overdose

2021 ◽  
pp. 175114372110077
Author(s):  
Mohammed Asif Arshad ◽  
Mansoor Nawaz Bangash
Keyword(s):  
Critical Care ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Correct Diagnosis ◽  
Paracetamol Overdose ◽  
Prior History ◽  
High Dose ◽  
The United Kingdom ◽  
Early Intubation ◽  
History Of

Background Acute liver failure is a rare syndrome comprising a coagulopathy of liver origin, jaundice and encephalopathy in a patient with no prior history of liver disease. Paracetamol overdose is the leading cause of acute liver failure in the United Kingdom and often presents with extrahepatic organ dysfunction requiring critical care. Presentation: We present the case of a patient with hyper acute liver failure secondary to paracetamol overdose. Management and discussion: Management focused on ensuring the correct diagnosis had been made, administering N-acetyl cysteine, fluid resuscitation and broad spectrum antimicrobials. Early intubation and transfer to a transplant centre were undertaken following development of hepatic encephalopathy. Neuroprotective measures and hypertonic saline were instituted to reduce the risk of intracranial hypertension. High dose haemofiltration was also started to help reduce ammonia levels. Aggressive critical care therapies with specialised input results in good outcomes for patients admitted with paracetamol induced hyper acute liver failure. Liver transplant is reserved for those patients unlikely to survive with medical treatment alone.

Plasmapheresis in Acute Liver Failure

1986 ◽  
Vol 9 (6) ◽  
pp. 433-438 ◽  
Author(s):  
J.G. Freeman ◽  
K. Matthewson ◽  
C.O. Record
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatic Failure ◽  
Serum Bilirubin ◽  
Hepatic Coma ◽  
Acute Hepatic Failure ◽  
Plasma Ammonia ◽  
Coma Grade ◽  
Better Than

A series of 9 patients with acute hepatic failure and Grade IV hepatic coma received daily plasmapheresis until they recovered or death ensued. Of the nine, seven (77%) showed an improvement in coma grade and five (55%) survived to leave hospital. Plasmapheresis significantly decreased serum bilirubin, asparate aminotransferase and plasma ammonia concentrations. Survival following plasmapheresis appeared substantially better than in a non randomized group of similar patients not plasmapheresed. The simplicity of the procedure, biochemical improvements observed and apparent efficacy, suggest that further evaluation of the technique as a means of providing temporary hepatic support is indicated.

Efficacy of high-dose corticosteroid in the early stage of viral acute liver failure

2013 ◽  
Vol 44 (5) ◽  
pp. 491-501 ◽  
Author(s):  
Keiichi Fujiwara ◽  
Shin Yasui ◽  
Yutaka Yonemitsu ◽  
Rintaro Mikata ◽  
Makoto Arai ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Early Stage ◽  
High Dose ◽  
High Dose Corticosteroid ◽  
Dose Corticosteroid

scholarly journals Use of the extracorporeal detoxification methods for methotrexate elimination

2021 ◽  
Vol 17 (8) ◽  
pp. 90-94
Author(s):  
R.Yu. Sobko ◽  
T.T. Borachok ◽  
T.B. Oranskyi ◽  
M.O. Kovalov ◽  
Kh.M. Zapotochna ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Clinical Case ◽  
Methylenetetrahydrofolate Reductase ◽  
Mthfr C677t ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Urine Alkalinization ◽  
Intravenous Hydration

The article considers a clinical case of a 12-year-old child with osteosarcoma of the left tibia, T1N0M0G3, treated with high-dose methotrexate 12 g/m2. As a result of delayed elimination of methotrexate, the patient developed acute liver failure. The ALT level increased to 4790 U/L, AST — to 4320 U/L, which indicates life-threatening acute liver damage. There was no coagulopathy, significant increase in bilirubin, and hepatic encephalopathy. The timely use of efferent therapy allowed avoiding the complete course of acute liver failure. The patient received intravenous hydration therapy and urine alkalinization with 3000 ml/m2/day of 5% glucose in combination with 20 μmol NaHCO3/L and 20 μmol KCl/L. The urine output was more than 600 ml/m2/6 hours. Additionally, antidote therapy with calcium folinate was administered. In this case, we used continuous venous-venous hemodiafiltration using Prismaflex. After the first session, which lasted for 78 hours, there was a re-increase in serum methotrexate concentration and ALT, AST levels, which indicates a large volume of distribution of methotrexate and the need for long-term extracorporeal therapy. Therefore, the second session of continuous venous-venous hemodiafiltration was provided. After the second session, there was no re-increase in methotrexate level in the blood and the transaminases and total bilirubin returned to normal levels. Additionally, the patient was tested for homocysteine levels for hyperhomocysteinemia, as well as 4 genes that also determine the predisposition to hyperhomocysteinemia — methylenetetrahydrofolate reductase gene MTHFR C677T, A1298C, methionine synthase MTRR, and MTR. The presence of elevated levels of homocysteine, as well as heterozygosity of these genes, indicate a slow excretion of methotrexate or a complete delay in its excretion. Our patient presented the negative results of these tests. Conclusions. This clinical case indicates the effectiveness of continuous venous-venous hemodiafiltration in combination with intravenous hydration, urine alkalinization, and antidote therapy in the treatment of hepatotoxicity of high-dose methotrexate on the background of delayed excretion.

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