Acute Liver Failure in the United States
Authors: William D. Carey, Raquel Marie Schears, William M. Lee, Anne Larson, Robert Fontana, George Ostapowicz
Journal: Annals of Internal Medicine (2003)

Letters16 December 2003Acute Liver Failure in the United StatesWilliam D. Carey, MDWilliam D. Carey, MDFrom Cleveland Clinic Foundation, Cleveland, OH 44195.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-12-200312160-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Ostapowicz and colleagues (1) provided important information about the causes of acute liver injury in the United States and the growing problem of intentional acetaminophen overdose. However, their study perpetuates confusion about the unproved perception that therapeutic doses of acetaminophen cause acute liver failure. Their series included 21 patients whose acute liver failure was attributed to acetaminophen despite ingestion of less than 4 g/d (in some cases as little as 2.6 g/d). Some patients with presumed acetaminophen acute liver failure had near-normal aspartate aminotransferase or alanine aminotransferase values. Attribution of cause and effect for such cases (18% ...References1. Ostapowicz G, Fontana RJ, Schiodt FV, Larson A, Davern TJ, Han SH, . Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med. 2002;137:947-54. [PMID: 12484709] LinkGoogle Scholar2. Gerber MA, Kaufmann H, Klion F, Alpert LI. Acetaminophen associated hepatic injury, Report of two cases showing unusual portal tract reactions. Hum Pathol. 1980;11:37-42. [PMID: 7364436] CrossrefMedlineGoogle Scholar3. Leist MH, Gluskin LE, Payne JA. Enhanced toxicity of acetaminophen in alcoholics: report of three cases. J Clin Gastroenterol. 1985;7:55-9. [PMID: 3980965] CrossrefMedlineGoogle Scholar4. Gunawan B, Carey WD. The effect of acetaminophen in patients with chronic liver disease [Abstract]. Gastroenterology. 2002;122:P188. MedlineGoogle Scholar5. Benson GD. Acetaminophen in chronic liver disease. Clin Pharmacol Ther. 1983;33:95-101. [PMID: 6848304] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: William D. Carey, MDAffiliations: From Cleveland Clinic Foundation, Cleveland, OH 44195. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResults of a Prospective Study of Acute Liver Failure at 17 Tertiary Care Centers in the United States George Ostapowicz , Robert J. Fontana , Frank V. Schiødt , Anne Larson , Timothy J. Davern , Steven H.B. Han , Timothy M. McCashland , A. Obaid Shakil , J. Eileen Hay , Linda Hynan , Jeffrey S. Crippin , Andres T. Blei , Grace Samuel , Joan Reisch , William M. Lee , and Acute Liver Failure in the United States Raquel Marie Schears Acute Liver Failure in the United States William M. Lee , Anne Larson , Robert Fontana , and George Ostapowicz Metrics 16 December 2003Volume 139, Issue 12Page: 1044-1045KeywordsAcute liver failureAlcoholismAlcoholsHepatitis BIngestionLiverLiver diseasesMalnutritionPerceptionSerum glutamic oxaloacetic transaminase ePublished: 16 December 2003 Issue Published: 16 December 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...