William D. Carey, MD
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Carey WD. Acute Liver Failure in the United States. Ann Intern Med. 2003;139:1044-1045. doi: 10.7326/0003-4819-139-12-200312160-00022
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Published: Ann Intern Med. 2003;139(12):1044-1045.
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% of all of the cases attributed to acetaminophen) may reasonably be questioned.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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