New assay to diagnose late acetaminophen toxicity

Roberts DW, Lee WM, Hinson JA et el published a observational cohort study in Clinical Gastroenterology and Hepatology journal about utility of  point-of-care assay to detect acetaminophen protein adducts in patients suspected to have acetaminophen toxicity.

They compared the accuracy of AcetaSTAT vs high-pressure liquid chromatography with electrochemical detection (HPLC-EC; a sensitive and specific quantitative analytic assay) to detect acetaminophen protein adducts in patients identified in Acute Liver Failure Study Group registry.

AcetaSTAT identified patients with acetaminophen-associated acute liver injury with 100% sensitivity, 86.2% specificity, a positive predictive value of 89.2%, and a negative predictive value of 100%.

Patients who present within 24 hours can be easily diagnosed and treated with usual acetaminophen nomograms. But when patient presents after 24 hours, risk of hepatic toxicity can not be predicted using nomograms. Hopefully we will have this assay available for use in the hospitals for the prediction of acetaminophen toxicity.

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