Letter to the Editor: Acute Liver Injury Due to Therapeutic Doses of Acetaminophen—Confounders Must Be Ruled Out!

We read the study by Louvet et al (1) describing risk factors and outcomes associated with acute liver injury due to therapeutic doses of acetaminophen (ALITD) with great interest. They conclude that ALITD is associated with severe liver injury and occurs in patients with excess alcohol consumption or fasting. This makes us ponder the mechanisms behind ALITD to prospectively modify host risk factors associated with therapeutic misadventure of acetaminophen. However, certain issues warrant further clarification.