Background: Paracetamol toxicity is a common toxicity that can result in severe hepatic
damage, which can progress to liver failure. Traditional liver markers, have limitations in early
detection. Aim: The present work aims to evaluate the efficacy of miRNA-122 serum level in
detecting the degree of liver affection in the early phases of acute paracetamol toxicity.
Methods: This prospective study was conducted by collecting demographic, clinical data and
blood samples from 35 acute single paracetamol toxicity patients admitted to the Poison Control
Centre of Ain Shams University. Liver function tests, serum miRNA-122 expression and
paracetamol level were measured on admission, at 24 and 48 hours. 35 controls matched to age
and gender, were used as a reference to the lab results. Results: The studied patients with acute
paracetamol toxicity were 10 males (28.6%) and 25 females (71.4%). Mean age was 25.3 years ±
6.7. The levels of miRNA-122 on admission were statistically significantly higher in patients
than in controls. The levels of ALT and INR increased statistically significantly over time,
whereas paracetamol and miRNA-122 decreased statistically significantly over time. MiRNA122 expression showed a strong positive correlation with the amount of paracetamol consumed,
ALT levels (p < 0.000), and length of hospital stay, and a moderate correlation with INR (p =
0.010). Conclusions: This study provides evidence supporting the potential role of miRNA-122
as a biomarker for early detection of the degree of liver injury in acute paracetamol toxicity
patients. MiRNA-122 demonstrated superior sensitivity and specificity compared to traditional
liver markers.