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Liver function and structure in survivors of acetaminophen poisoning

A follow-up study of serum bile acids and liver histology

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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

  1. Proudfoot AT, Wright N: Acute paracetamol poisoning. Br Med J 3:557–558, 1970

    Google Scholar 

  2. 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.

    Google Scholar 

  3. James OFW, Lesna M, Roberts SH, Pulman L, Douglas AP, Smith PA, Watson AJ: Liver damage after paracetamol overdose. Lancet 2:579–581, 1975

    Google Scholar 

  4. 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

    Google Scholar 

  5. Routh JR, Shane NA, Arrendondo EG, Paul WD: Determination ofN-acetylp-aminophenol in plasma. Clin Chem 14:882–889, 1968

    Google Scholar 

  6. 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

    Google Scholar 

  7. Douglas AP, Hamlyn AN, James O: Controlled trial of cysteamine in treatment of acute paracetamol (acetaminophen) poisoning. Lancet 1:111–115, 1976

    Google Scholar 

  8. Dixon MF, Nimmo J, Prescott LF: Experimental paracetamol-induced hepatic necrosis; a histopathological study. J Pathol 103:225–229, 1971

    Google Scholar 

  9. 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.

    Google Scholar 

  10. Kaplowitz N, Kok E, Javitt NV: Postprandial serum bile acid for the detection of hepatobiliary disease. JAMA 225:292–293, 1973

    Google Scholar 

  11. 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

    Google Scholar 

  12. 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

    Google Scholar 

  13. 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

    Google Scholar 

Download references

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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

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