Patterns of transaminase elevation in rhabdomyolysis versus acetaminophen toxicity

AbstractBackgroundTransaminase elevations can occur from liver injury or in the setting of rhabdomyolysis. The goal of this study is to evaluate indices that could differentiate acetaminophen toxicity from muscle injury in the setting of transaminase elevations. MethodsA retrospective chart review o...

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Bibliographic Details
Published in:The American journal of emergency medicine 2021-06, Vol.44, p.362-365
Main Authors: Maskell, Kevin F, Powell, Scott W, Willis, Deanna, Okhomina, Victoria, Sima, Adam P, Wills, Brandon K
Format: Article
Language:English
Subjects:
Acetaminophen
Acetaminophen toxicity
Aminotransferase
Analgesics
Creatine
Creatine kinase
Creatinine
Data collection
Emergency
Emergency medical care
Ingestion
Laboratories
Liver
Liver diseases
Patients
Rhabdomyolysis
Toxicity
Transaminase
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Summary:AbstractBackgroundTransaminase elevations can occur from liver injury or in the setting of rhabdomyolysis. The goal of this study is to evaluate indices that could differentiate acetaminophen toxicity from muscle injury in the setting of transaminase elevations. MethodsA retrospective chart review of consecutive cases reported to our regional poison center. Patients with transaminase (AST and ALT) elevation were grouped as those with acetaminophen exposure (AT) and those with elevated creatine phosphokinase (CPK) without evidence of acetaminophen exposure (RHB). ResultsOf the 345 patients included in the study, elevated AST/ALT levels were attributed to rhabdomyolysis in 168 patients and attributed to acetaminophen toxicity in 177 patients. The median AST: ALT values also differed between groups, with patients in the RHB group had higher median ratios ( p 
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2020.04.061