A 36-Year-Old Woman with Acute Liver Failure Following Acetaminophen Overdose, Raised INR of 8.7, and Normal Blood Viscosity Measured by Rotational Thromboelastometry (ROTEM)

31 January 2023: Articles

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care

Uzung Yoon ^A* , Manny Lai ^E , Tho Nguyen ^E , Elia Elia ^E

DOI: 10.12659/AJCR.938500

Am J Case Rep 2023; 24:e938500

Table 1. Conventional coagulation testing values and viscoelastic coagulation testing values during patient’s hospital stay.

	Ref. range	Day 1 21: 56	Day 2 12: 11	Day 2 18: 25	Day 3 02: 04	Day 3 03: 10	Day 3 07: 18	Day 3 16: 19
PT	8.9–13.1 sec	>100.0	>100.0	56.1	32.1	34.0	24.0	40.5
INR	0.81–1.19	>8.71	>8.71	4.94	2.86	3.02	2.15	3.59
PTT	24–35 sec	30	35	32	28	29	26	35
D-Dimer		10658	10515	7649	5772	5979	6207	21797
Fibrinogen	204–462 mg/dL	116	94	120	218	198	231	138
Notes			ROTEM 2FFP	2FFP 2CRYO	3FFP 3CRYO	2FFP		Central line placed
PT – prothrombin time; PTT – partial thromboplastin time; INR – international normalized ratio; ROTEM – rotational thromboelastometry; CRYO – cryoprecipitate.
	Ref. range	Day 4 11: 25	Day 4 17: 45	Day 5 00: 16	Day 5 07: 57	Day 5 16: 12	Day 6 00: 08	Day 6 08: 29
PT	8.9–13.1 sec	43.0	43.7	25.9	33.6	31.5	33.4	25.8
INR	0.81–1.19	3.80	3.86	2.31	2.99	2.80	2.97	2.31
PTT	24–35 sec	34	35	33	35	35	42	37
D-Dimer		18442	16097	>69000	66681	49010	>69000	65573
Fibrinogen	204–462 mg/dL	108	96	118	69	134	40	118
Notes			2FFP 3CRYO		2 CRYO		2 CRYO
PT – prothrombin time; PTT – partial thromboplastin time; INR – international normalized ratio; ROTEM – rotational thromboelastometry; CRYO – cryoprecipitate.