22 February 2020 : Case report
The MicroRNA-based Liquid Biopsy Improves Early Assessment of Lethal Acetaminophen Poisoning: A Case Report
Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Adverse events of drug therapy, Clinical situation which can not be reproduced for ethical reasons
Julian Krauskopf1CDE*, Mark M. Gosink2CDE, Shelli Schomaker3BDE, Florian Caiment1C, Roscoe Warner2ADE, Kent Johnson2ABD, Jos Kleinjans1ADE, Jiri Aubrecht3ADEFGDOI: 10.12659/AJCR.919289
Am J Case Rep 2020; 21:e919289
Abstract
BACKGROUND: Acetaminophen overdose is the most common cause of acute liver failure. Nevertheless, new biomarker approaches enabling early prediction of the outcome of the acetaminophen overdose are needed. Recently, using next-generation sequencing analysis of serum from human study participants we uncovered injury-specific signatures of circulating microRNAs (miRNAs) that represented underlying molecular mechanisms of toxicity. This case study is first to show the application of miRNA profiling to assess prognosis of acetaminophen poisoning.
CASE REPORT: The patient was admitted to the hospital following supra therapeutic acetaminophen ingestion. The patient showed elevated levels of biomarkers of hepatocellular injury alanine aminotransferase, aspartate transaminase, and glutamate dehydrogenase. Even though treatment with N-acetyl cysteine was initiated 24 hours post-ingestion, levels of alanine-aminotransferase and aspartate transaminase peaked at about 40 hours post ingestion of acetaminophen. We analyzed global circulating miRNA levels from 24 consecutive serum samples from this study participant covering the period from admission to time of death.
CONCLUSIONS: The resulting global miRNA profiles were compared with profiles from study participants with non-lethal acetaminophen poisoning and healthy controls. At the admission, the miRNA profiles of both lethal and non-lethal acetaminophen poisoning showed induction of cellular stress and oxidative damage. Later, the miRNA profiles of the lethal poisoning featured fibrosis and coagulation pathways while profiles of non-lethal cases resembled those of healthy study participants. Although additional confirmatory studies are needed, our case study is first to indicate that global miRNA profiles to be used as liquid biopsies have potential to facilitate the assessment of acetaminophen poisoning.
Keywords: Acetaminophen, Biological Markers, Chemical and Drug Induced Liver Injury, Drug Overdose, Fatal Outcome, Liquid Biopsy
In Press
Case report
Acute Extensor Pollicis Longus Tendon Injury Associated with a Distal Radius Fracture: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.946399
Case report
Severe Neonatal Asphyxia Associated with Ureaplasma urealyticum Infection: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.946249
Case report
Impact of Lupus Anticoagulant on INR Using Recombinant Prothrombin Time ReagentAm J Case Rep In Press; DOI: 10.12659/AJCR.945579
Case report
Cerebral Air Embolism Risks in TAVR Procedures: Insights from a 75-Year-Old Patient CaseAm J Case Rep In Press; DOI: 10.12659/AJCR.946254
Most Viewed Current Articles
21 Jun 2024 : Case report 82,922
Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report 49,170
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
20 Nov 2023 : Case report 23,646
Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile InfectionDOI :10.12659/AJCR.941424
Am J Case Rep 2023; 24:e941424
18 Feb 2024 : Case report 22,139
A Case of Thoracic Empyema Caused by Actinomyces naeslundiiDOI :10.12659/AJCR.943030
Am J Case Rep 2024; 25:e943030