title: Role of laboratory in the management of phenylbutazone poisoning.
abstract: We report a rare case of intentional overdose of phenylbutazone in a 15-yr-old female. The patient exhibited symptoms of phenylbutazone toxicity and the presence of the drug was confirmed by gas chromatography mass-spectrometry (GC-MS) analysis of the initial urine sample. The patient underwent plasmapheresis to remove the drug from the circulation. Semiquantitation of sequential serum samples by GC-MS revealed elimination of phenylbutazone by day 5 of admission at which time the plasmapheresis was discontinued. Elevated blood urea nitrogen (BUN) and creatinine returned to normal. Analysis of biomarkers for liver necrosis and regeneration in sequential serum samples revealed the restoration of normal liver function by day 5. This case further confirms our previous observations that biomarkers for liver necrosis and regeneration can predict the outcome of patients with liver damage due to toxins.
authors.affiliation: Department of Pathology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Virji
authors.forename: Shekhar T
authors.initials: ST
authors.lastname: Venkataraman
authors.forename: Darla R
authors.initials: DR
authors.lastname: Lower
authors.forename: Kalipatnapu N
authors.initials: KN
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000506:poisoning* / Q000652:urine; D015415:Biomarkers / Q000097:blood; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007755:Laboratories, Hospital; D008099:Liver / Q000503:physiopathology; D008111:Liver Function Tests; D010653:Phenylbutazone / Q000506:poisoning* / Q000652:urine; D011041:Poisoning / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D010653:Phenylbutazone