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Hepatotoxicity and persistent renal insufficiency after repeated supratherapeutic paracetamol ingestion in a Chinese

K L Kwok1, Y M Fu, D K K Ng

  • 1Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong. cklkwok@yahoo.com

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|February 18, 2004
PubMed

Insights

Repeated supratherapeutic paracetamol ingestion can cause serious toxicity in children, including liver damage and persistent kidney problems. This case highlights the underrecognized risk of chronic paracetamol poisoning in pediatric patients.

Area of Science:

  • Pediatric Toxicology
  • Pharmacology
  • Nephrology

Background:

  • Paracetamol (acetaminophen) is widely considered safe and effective.
  • The risks associated with repeated supratherapeutic paracetamol dosing are not well recognized.

Observation:

  • A 12-month-old boy presented with severe health issues.
  • These included hepatotoxicity, disseminated intravascular coagulation, and persistent renal insufficiency.
  • These symptoms appeared 4 days after repeated ingestion of excessive paracetamol dosage.

Findings:

  • This is the first reported case of chronic paracetamol poisoning in a pediatric patient within the Chinese population.
  • Persistent renal insufficiency is a newly identified feature of chronic paracetamol poisoning.
  • The study proposes that hypoperfusion combined with paracetamol overdose synergistically causes renal damage.

Implications:

  • Clinicians should be aware of the potential for severe toxicity from chronic paracetamol overdose in children.
  • Persistent renal insufficiency may be a consequence of such poisoning.
  • Further research is needed to understand the mechanisms of paracetamol-induced renal damage.

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