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56 However, if the patient continues to present evidence of liver dysfunction beyond persistent ALT elevation (satisfying KCH criteria of acidosis, elevated creatinine, hyperbilirubiniemia, coagulopathy and encephalopathy), then NAC therapy should be continued as these indicators portend a poor prognosis regardless of transaminase levels

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It also modulates the HO-1/PPAR/Wnt/-catenin signaling axis, promoting NO production and E-cadherin expression to suppress fibrotic responses [85]