Biomarkers of liver regeneration allow early prediction of hepatic recovery after acute necrosis

Acute toxic hepatic necrosis is common and may be fatal. Predicting clinica l outcome may be aided by following serum markers that could indicate recov ery or may signify massive (substantial) destruction of functional liver ma ss. Previously: in a published case of chloroform poisoning. we serially as sayed serum biomarkers of hepatocellular necrosis (aspartate aminotransfera se, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase) and markers of hepatocellular regeneration (alpha-fetoprotein, retinol-bind ing protein, gamma-glutamyl transferase, and des-gamma- carboxyprothrombin) . We noted a decline in necrotic markers and synchronous elevation in regen erative markers, which could be suggestive of a favorable outcome in simila r cases. We now report 6 Amanita mushroom poisonings with favorable outcome and 2 fatal acetaminophen poisonings in which the same markers were observ ed. Our results further support our hypothesis that a sustained decline in serum markers of hepatocyte necrosis with a concurrent elevation in regener ative markers could aid in prediction of favorable outcome in patients with acute liver injury.