ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2019
Rodenticidal hepatotoxicity: Raised plasma Von Willebrand factor levels predict in-hospital survival and preliminary report of the outcome of Von Willebrand factor reducing management protocol.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Plasma exchange to treat liver failure: The field expands.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- Yellow phosphorus poisoning: is preemptive PLEX therapy feasible?The Lancet regional health. Southeast Asia · 2024Article
- Extra-corporeal non-liver transplant therapies for acute liver failure: Focus on plasma exchange and continuous renal replacement therapy.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Changing trends in the profile of rodenticide poisoning.Medical journal, Armed Forces India · 2022Article
- Rodenticide ingestion is an important cause of acute hepatotoxicity in Tamil Nadu, southern India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021Article
- Targeting von Willebrand factor in liver diseases: A novel therapeutic strategy?Journal of thrombosis and haemostasis : JTH · 2021Review
- Targeting raised von Willebrand factor levels and macrophage activation in severe COVID-19: Consider low volume plasma exchange and low dose steroid.Thrombosis research · 2020Article
- Improving Transplant-free Survival With Low-volume Plasma Exchange to Treat Children With Rodenticide Induced Hepatotoxicity.Journal of clinical and experimental hepatologyArticle
- Growing Evidence for Survival Benefit with Plasma Exchange to Treat Liver Failure.Journal of clinical and experimental hepatologyReview
- Recognizing Dysfunctional Innate and Adaptive Immune Responses Contributing to Liver Damage in Patients With Cirrhosis.Journal of clinical and experimental hepatologyReview
- Single-Centre Experience With Low-Volume Plasma Exchange and Low-Dose Steroid to Treat Patients With Idiosyncratic Drug-Induced Acute Liver Failure.Journal of clinical and experimental hepatologyArticle
- Rodenticide (Yellow Phosphorus Poison)-Induced Hepatotoxicity in India: Constraints During Management.Journal of clinical and experimental hepatologyArticle
- Von Willebrand Factor as a Biomarker for Liver Disease - An Update.Journal of clinical and experimental hepatologyReview
- Liver Transplantation Society of India Guidelines for the Management of Acute Liver Injury Secondary to Yellow Phosphorus-Containing Rodenticide Poisoning Using the Modified Delphi Technique of Consensus Development.Journal of clinical and experimental hepatologyArticle
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Abstract
backgroundHigh Von Willebrand factor (VWF) levels may predispose to multi-organ failure in acute liver failure (ALF). In rodenticide-induced hepatotoxicity patients, we analyzed if plasma VWF levels predicted survival and also the outcome of VWF lowering by N-acetyl cysteine (NAC), fresh frozen plasma (FFP) infusions, and plasma exchange (PLEX).
methodsWe retrospectively analyzed prospectively collected data. Hepatotoxicity was classified as uncomplicated acute hepatitis (UAH), acute liver injury (ALI), and ALF. ALF patients, if not opting for liver transplantation, had PLEX and NAC; ALI patients received NAC ± FFP (PLEX, if worsening); UAH patients had NAC. Plasma VWF antigen was measured (normal, 50% to 150%). In-hospital survival was analyzed as discharged alive or died/discharged in a terminal condition (poor outcome).
resultsTwenty-four consecutive rodenticide-induced hepatotoxicity patients (UAH in 1, ALI in 20, ALF in 3) from December 2017 to January 2019 were studied. Baseline VWF levels were 153%, 423 (146-890)% median (range), and 448 (414-555)% in UAH, ALI, ALF patients; model for end-stage liver disease (MELD) scores were 11, 24 (12-38), 36 (32-37) and in-hospital survival rates were 100%, 85%, 67%, respectively. VWF levels were higher in patients with poor outcome (555 [512-890]%) than in those discharged alive (414 [146-617]%) (p-value = 0.04). The area under the receiver operating curve of the VWF level, MELD score, and sequential organ failure assessment score to predict survival was 0.92, 0.84, and 0.66, respectively. Of 4 patients meeting criteria for liver transplantation (none had transplantation), 3 (75%) survived.
conclusionsHigh VWF levels predict poor outcome in rodenticide-induced hepatotoxicity. VWF reduction may be useful in such patients.
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