2010
DOI: 10.1007/s12072-010-9176-4
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Intravenous N-acetylcysteine in dengue-associated acute liver failure

Abstract: We read with interest the article by Mumtaz et al. [1] on the role of oral N-acetylcysteine (NAC) in adults with nonacetaminophen-induced acute liver failure. We agree that their findings are of particular relevance to many developing countries, where liver transplantation is neither available nor affordable. There has been another recent study in which intravenous NAC has been shown to improve transplant-free survival in early-stage non-acetaminophen-induced acute liver failure in adults [2]. We report our in… Show more

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Cited by 50 publications
(32 citation statements)
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“…Intravenous NAC improves transplant-free survival in early stage non-acetaminophen acute liver failure. Several case reports and case series suggest early use of NAC many improve survival in dengue associated ALF [4]. Early prediction and recognition of ALF in DI may, therefore, be helpful to identify patients who may benefit from treatment with intravenous NAC.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Intravenous NAC improves transplant-free survival in early stage non-acetaminophen acute liver failure. Several case reports and case series suggest early use of NAC many improve survival in dengue associated ALF [4]. Early prediction and recognition of ALF in DI may, therefore, be helpful to identify patients who may benefit from treatment with intravenous NAC.…”
Section: Discussionmentioning
confidence: 99%
“…Although the true incidence is not known, dengue associated ALF is not uncommon and has a poor prognosis [2,3]. Early identification of impending ALF in DI will help clinicians to identify patients who will benefit from interventions such as intravenous N-acetyl cysteine (NAC) [4]. The objective of this study was to identify early clinical and biochemical predictors of ALF in DI.…”
Section: Introductionmentioning
confidence: 99%
“…There are a few studies with successful use of Nacetylcysteine in non-acetaminophen induced acute liver failure including dengue fever [7,8,9]. NAC may benefit patients with nonacetaminophen induced acute liver failure by improving systemic haemodynamics, by tissue oxygen delivery or via other favourable effects on the acutely injured liver.…”
Section: Discussionmentioning
confidence: 99%
“…NAC may benefit patients with nonacetaminophen induced acute liver failure by improving systemic haemodynamics, by tissue oxygen delivery or via other favourable effects on the acutely injured liver. The benefit is seen when NAC is used in the early stages of liver failure but not when it is advanced [8,9] . This patient presented with dengue haemorrhagic fever with acute liver failure and grade 2 hepatic encephalopathy.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, organ failure should be treated on its own merits. There are ongoing efforts to develop specific antiviral drugs and other treatment modalities that may improve the outcome of dengue infection [37] and its associated organ specific complications, such as, the use of N-acetylcysteine in ALF [38,39]. More research, including randomised clinical trials, is required to replace much of the dogma with evidence based management practices.…”
Section: Treatment and Preventionmentioning
confidence: 99%