Naslov
Late-presenting acetaminophen self- poisoning: a case report

Autori
Benco N ; Lovrić M ; Rešić A

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Arhiv za higijenu rada i toksikologiju / Irena Brčić Karačonji, Nevenka Kopjar - Zagreb, 2021, 36-36

Skup
6th Croatian congress of toxicology with international participation (CROTOX 2021)

Mjesto i datum
Rabac, Hrvatska, 03.10.2021. - 06.10.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
acute hepatic injury ; immunoassay ; N-acetylcysteine ; suicide ; toxicity

Sažetak
Acetaminophen is one of the most commonly used analgesic and antipyretic due to its low price, over the counter availability and big packaging. Therefore, acetaminophen overdose is very often and it is the most common drug-related toxicity reported to poison centres. Ingestion over 200 mg/kg or 10 g in a single dose is considered toxic and overwhelms conjugation pathways of acetaminophen metabolism in the liver, resulting in increased formation of N-acetyl-p- benzoquinone imine (NAPQI) which causes hepatic injury. We report a case of a 15-year-old adolescent girl admitted in Intensive Care Unit (ICU) of Children’s Hospital Zagreb 38 hours after having ingested 13.5 grams of acetaminophen as a suicide attempt. Due to ingestion of toxic acetaminophen dose, N-acetylcysteine (NAC) was initiated following the 21-hour NAC protocol. Blood test revealed elevated levels of transaminase, high ammonia values and coagulopathy. Abdominal ultrasound reported diffusely enlarged hypoechoic liver with hypoechoic area, which may correspond with necrosis zone. Serum acetaminophen levels were measured daily with immunoassay (EMIT® tox™ Siemens). In initial sample, 36 hours after ingestion, level was 557 μmol/L. Acetaminophen was detectable until seventh day after ingestion, so NAC was discontinued after 6 days of treatment, when concentrations were undetectable and liver enzymes decreased. She did not develop any criteria for liver transplantation and was discharged on day 15 after ingestion. On her check-up one month later transaminase levels were in normal range. In conclusion, in this case late administration of NAC proved to be beneficial in the treatment of acetaminophen induced liver injury.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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