Abstract
A series of 30 patients, hospitalized with acetaminophen overdose, were studied during initial admission and again three months later. The quantity of acetaminophen ingested varied from 5 to 50 g and 19 patients developed raised transaminase levels in the serum during the initial period. Liver damage, on the basis of needle biopsy findings, was categorized as severe in 5, moderate in 7, and mild or minimal in 18 patients. At three months' follow-up all but one of the biochemical indicatns of liver damage had reverted to normal in all patients. The exception was the serum total bile acids. Residual changes found on liver biopsy at three months were minimal and nonspecific, apart from one previously severely affected patient in whom there was evidence of scarring. It is concluded that in the usual spectrum of acetaminophen poisoning requiring hospitalization there is no evidence of lasting liver damage.
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References
Proudfoot AT, Wright N: Acute paracetamol poisoning. Br Med J 3:557–558, 1970
Clark R, Thompson RPH, Borkrakchanyurat V, Widdop B, Davidson AR, Williams R: Hapatic damage and death from overdose of paracetamol. Lancet 1:66–69, 1973.
James OFW, Lesna M, Roberts SH, Pulman L, Douglas AP, Smith PA, Watson AJ: Liver damage after paracetamol overdose. Lancet 2:579–581, 1975
Murphy GM, Billing BH, Baron DN: A fluorometric and enzymatic method for estimation of serum total bile acids. J Clin Pathol 23:594–598, 1970
Routh JR, Shane NA, Arrendondo EG, Paul WD: Determination ofN-acetylp-aminophenol in plasma. Clin Chem 14:882–889, 1968
Prescott LF, Newton RW, Swainson CP, Wright N, Forrest ARW, Matthew H: Successful treatment of severe paracetamol overdosage with cysteamine. Lancet 1:588–592, 1974
Douglas AP, Hamlyn AN, James O: Controlled trial of cysteamine in treatment of acute paracetamol (acetaminophen) poisoning. Lancet 1:111–115, 1976
Dixon MF, Nimmo J, Prescott LF: Experimental paracetamol-induced hepatic necrosis; a histopathological study. J Pathol 103:225–229, 1971
Franz B, Bode JC: Plasma-gallensaurekonzentration (RGK): Nuchternwerte, tagesschankungen und einfluss intraduodenaler gallensaurezufuhr bei gesunden und patientien mid chronischer leberkrankheiten. Z Gastroenterol 11:131–134, 1973.
Kaplowitz N, Kok E, Javitt NV: Postprandial serum bile acid for the detection of hepatobiliary disease. JAMA 225:292–293, 1973
Barnes S, Gallo GA, Trash DB, Morris JS: Diagnostic value of serum bile acid estimations in liver disease. J Clin Pathol 28:506–509, 1975
Cronholm T, Norman A, Sjovall J: Bile acids and steroid sulphates in serum of patients with infectious hepatitis. Scand J Gastroenterol 5:297–303, 1970
Korman MG, Hofmann AF, Summerskill WHJ: Assessment of activity in chronic active liver disease: serum bile acids compared with conventional tests and histology. N Engl J Med 290:1399–1402, 1974
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Part of this work was supported by a grant from the University Hospitals Scientific and Research Committee.
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Hamlyn, A.N., Douglas, A.P., James, O.F.W. et al. Liver function and structure in survivors of acetaminophen poisoning. Digest Dis Sci 22, 605–610 (1977). https://doi.org/10.1007/BF01073078
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DOI: https://doi.org/10.1007/BF01073078