FIG. 3.

Serial ¹³C-MBT results in a DILI patient with ALF patient who survived and a DILI patient with ALI who required LT. (A) A 52-year-old female with presumed DILI due to tizanidine and ropinirole was enrolled with a MELD score of 26 and a total bilirubin of 9.3 mg/dL, INR of 2.8, and grade 3 hepatic encephalopathy. Her ALFSG prognostic score was 7.7% likelihood of 21-day TFS. She received intravenous N-acetylcysteine on day 1 and was on famotidine starting on day 2, but never on pressors nor intubated. Over time her clinical status improved and by day 7 her hepatic encephalopathy grade was 1 and she was discharged to go home at day 14. Her ¹³C-MBT results improved from day 2 through day 7. (B) A 53-year-old female with DILI due to clindamycin was enrolled with ALI and no encephalopathy. During follow-up, she rapidly deteriorated and was listed for LT. Her initial MELD score was 30. She was never on pressors but was intubated on day 6. She eventually underwent LT on study day 7 and was discharged to go home on day 20. Her ¹³C-MBT results demonstrated a very low PDR peak that never improved.