Predicting outcome of paracetamol poisoning by use 14C-aminopyrine breath test.

Saunders, John B.; Wright, N.; Lewis, K O

doi:10.1136/bmj.280.6210.279

Cited by 60 publications

(53 citation statements)

References 6 publications

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“…The prognostic accuracy of 13 C-ABT has already been proven in conditions of acute liver damage, such as alcoholic hepatitis or fulminant liver failure [30,31]. In these cases, 13 C-ABT has been demonstrated to reliably predict histological severity, clinical improvement and short-term survival more than conventional liver function tests.…”

Section: Discussionmentioning

confidence: 97%

13C-Aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C

Rocco

Nucci

Valente

et al. 2012

Journal of Hepatology

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Section: Discussionmentioning

confidence: 97%

13C-Aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C

Rocco

Nucci

Valente

et al. 2012

Journal of Hepatology

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“…Methionine, which acts as a glutathione precursor [34], has been used in Great Britain as an oral antidote against APAP, and has protected against hepatic and renal toxicity when given within 8 to 10 hours of ingestion [35]. However, in some cases it may exacerbate hepatic encephalopathy when administered after the first hour of APAP ingestion [36]. Cimetidine, a histamine-2 receptor antagonist, inhibits cytochrome P-450 and in animal models has been found to decrease APAP toxicity [37,38].…”

Section: Treatment Of Intentional Apap Overdosementioning

confidence: 97%

Management of drug-induced liver disease

Marino¹,

Zimmerman²,

Lewis

2001

Curr Gastroenterol Rep

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The treatment and prevention of drug-induced liver injury starts with the recognition of hepatotoxicity at the earliest possible time so that the suspected drug can be discontinued expeditiously. Both liver enzyme monitoring and vigilance for signs of hypersensitivity involving the liver are useful strategies for many agents known to cause hepatocellular necrosis leading to liver failure. Specific antidotes to prevent or limit hepatic damage exist for only a few drugs, the most important being N-acetylcysteine for the treatment of acetaminophen hepatotoxicity. Corticosteroids are of unproven benefit in the setting of fulminant failure. Ursodiol may be helpful in instances of cholestatic injury. For other agents, supportive measures and the increasing use of liver-assist devices as well as emergency liver transplantation are available when drug injury evolves into irreversible liver failure. It is hoped that a better understanding of hepatotoxicity mechanisms will lead to the development of more specific and effective forms of therapy in the near future.

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“…The test is also a useful indicator of survival in alcoholic hepatitis and in patients with drug-induced hepatitis caused by acetaminophen overdose (1,4). The results of the ABT reflect hepatic microsomal enzyme function (5, 6) and have also been useful for monitoring the effects of a number of drugs on hepatic drug metabolism.…”

mentioning

confidence: 98%

The aminopyrine breath test does not correlate with histologic disease severity in patients with cholestasis

et al. 1987

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To determine whether the aminopyrine breath test can be used to document the presence of cirrhosis in patients with cholestatic liver disease, 19 patients (13 primary biliary cirrhosis, 4 sclerosing cholangitis and 2 chronic extrahepatic bile duct obstruction) underwent clinical and biochemical evaluations, liver biopsies and an aminopyrine breath test. Results were compared with those in 10 patients with biopsy-proven chronic active hepatitis with bridging and/or cirrhosis and in 22 healthy subjects. The aminopyrine breath test results in the 10 cholestatic patients with cirrhosis were not significantly different from the results in precirrhotic cholestatic patients (mean +/- S.D., 11.2 +/- 5.0 vs. 11.6 +/- 2.8% dose per 2 hr, p greater than 0.05) or healthy subjects (11.5 +/- 2.9% dose per 2 hr). In contrast, the results in the patients with chronic hepatitis were markedly depressed (3.2 +/- 1.9% dose per 2 hr, p less than 0.05). The aminopyrine breath test results did not correlate with results of conventional liver function tests in the cholestatic patients. These results demonstrate that the aminopyrine breath test is not clinically useful in identifying the presence of cirrhosis in patients with cholestatic liver disease, and provide further evidence that decreased microsomal enzyme function is a late feature of cholestatic liver disease.

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Predicting outcome of paracetamol poisoning by use 14C-aminopyrine breath test.

Abstract: Summary and conclusionsThe 14C-aminopyrine ('4C-amidopyrine)

Cited by 60 publications

References 6 publications

13C-Aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C

13C-Aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C

Management of drug-induced liver disease

The aminopyrine breath test does not correlate with histologic disease severity in patients with cholestasis

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