Which of the following effects of alcohol most likely contributed to this patient’s condition?
A previously healthy 42-year old Asian woman is brought to the emergency department because of a 24-hour history of nausea, vomiting and progressive lethargy. She has smoked 1 pack of cigarettes daily for 25 years and drinks four glasses of wine daily. She uses high-dose acetaminophen daily for headaches. She does not use illicit drugs. She is 155 cm (5ft 1 in) tall and weighs 50 kg (110 lb); BMI is 21 kg/m2. She is responsive to painful stimuli. Initial laboratory studies show increased hepatic aminotransferase.
A. Decreased generation of N-acetyl-p-benzoquinonelmine B. Increased glucuronidation C. Increased hepatic glutathione stores D. Increased sulfation E. Induction of cytochrome P450
The answer to this is letter E. What is Cytochrome 450? This is a type of enzyme that is responsible for metabolizing the different toxic compounds that may enter the body. This will be in charge of removing drugs that are not needed as well as other toxins that may be causing harm to the body.
The fact that the Asian woman has suddenly become unhealthy in a span of 24 hours means that there is something wrong with this type of enzyme. There are supposed to be 57 human genes that are meant to improve the overall function of the body to get rid of toxins but the things that are being experienced by the patient shows that there is something wrong.