Acute liver failure linked to OxyShred pre-workout supplement: A case report and review of literature

Table 1 Serologic work-up for etiology of acute liver failure

Laboratory test	Result	Reference range
Viral serologies
Hepatitis A, IgM	Negative	Negative
Hepatitis B, surface antigen	Negative	Negative
Hepatitis B, core antibody	Negative	Negative
Hepatitis B, quantitative PCR	Not detected	Not detected
Hepatitis C, antibody	Negative	Negative
Hepatitis E, quantitative PCR	Not detected	Not detected
Herpes simplex virus 1/2 PCR	Not detected	Not detected
Epstein-Barr virus, quantitative PCR	Not detected	Not detected
Cytomegalovirus, quantitative PCR	Not detected	Not detected
Autoantibody titers
Immunoglobulin G	1265 mg/dL	700-1600 mg/dL
Antinuclear antibody	Positive	Negative
Antinuclear antibody titer	1:80	< 1:80
Mitochondria M2 antibody	1.3 U/mL	< 4.0 U/mL
Smooth Muscle antibody	10 U	< 20 U
Genetic liver disease work-up
Ceruloplasmin	17 mg/dL (L)	18-51 mg/dL
Copper, serum	60 μg/dL	77-206 μg/dL
Iron	212 μg/dL (H)	37-145 μg/dL
Total iron binding capacity	< 229 μg/dL (L)	250-450 μg/dL
Ferritin	912 ng/mL (H)	13-150 ng/mL
Alpha-1-antitrypsin	86 mg/dL (L)	90-200 mg/dL
Blood toxicology panel
Phenobarbital level	< 2.4 μg/mL	10.0-40.0 μg/mL
Salicylate level	< 0.3 mg/dL	3.0-10.0 mg/dL
Acetaminophen level	< 5 μg/mL	10-30 μg/mL
Ethanol	< 10 mg/dL	< 10 mg/dL
Tricyclic antidepressant screen	< 100 ng/mL	Variable
Phosphatidylethanol	< 10 ng/mL	< 10 ng/mL

PCR: Polymerase chain reaction; IgM: Immunoglobulin M.