对乙酰氨基酚过量和急性肝损伤病例中降钙素原极度升高。
Extremely Elevated Procalcitonin in a Case of Acetaminophen Overdose and Acute Liver Injury.
机构信息
Department of Medicine, John A. Burns School of Medicine, University of Hawai 'i, USA.
Hospitalist Program, Queen's Medical Center, USA.
出版信息
Intern Med. 2022 Jan 1;61(1):115-118. doi: 10.2169/internalmedicine.7192-21. Epub 2021 Jun 26.
We herein report a 46-year-old man who suffered an intentional acetaminophen overdose. Laboratory results revealed leukocytosis and an elevated procalcitonin level (8.48 ng/mL). Computed tomography showed findings suggesting possible colitis. Due to concerns about sepsis in addition to acetaminophen overdose, oral N-acetyl cysteine and piperacillin/tazobactam were started. His procalcitonin levels further increased; however, the patient remained afebrile, and the C-reactive protein levels were normal. Piperacillin/tazobactam was discontinued, and he remained stable without antibiotics. The present case shows that the toxicokinetics of acetaminophen overdose can cause an elevated procalcitonin level. Furthermore, procalcitonin levels alone should not guide the need for antibiotics in such cases.
我们在此报告一例 46 岁男性患者，因故意服用过量对乙酰氨基酚而就诊。实验室结果显示白细胞增多和降钙素原水平升高（8.48ng/mL）。计算机断层扫描显示可能存在结肠炎的征象。由于除了对乙酰氨基酚过量外还存在脓毒症的担忧，给予口服 N-乙酰半胱氨酸和哌拉西林/他唑巴坦治疗。他的降钙素原水平进一步升高；然而，患者仍无发热，C 反应蛋白水平正常。停用哌拉西林/他唑巴坦后，患者情况稳定且未使用抗生素。本病例表明，对乙酰氨基酚过量的毒代动力学可能导致降钙素原水平升高。此外，在这种情况下，单独的降钙素原水平不应该指导使用抗生素的必要性。
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