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Multisystem failure and hepatic microvesicular fatty metamorphosis associated with tolmetin ingestion

G R Shaw1, W R Anderson

  • 1Department of Pathology and Laboratory Medicine, Hennepin County Medical Center, Mineapolis, Minn. 55415.

Archives of Pathology & Laboratory Medicine
|August 1, 1991
PubMed

Insights

Nonsteroidal anti-inflammatory drugs can cause multisystem toxicity. A fatal case in a teen girl linked tolmetin to multisystem failure and unique liver microvesicular fatty changes, a novel finding.

Area of Science:

  • Toxicology
  • Hepatology
  • Nephrology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain and inflammation.
  • NSAID use has been associated with multisystem toxicity, including renal and hepatic dysfunction.
  • Previous reports highlight potential NSAID-induced organ damage.

Observation:

  • A fatal case of multisystem failure in a 15-year-old female following tolmetin ingestion is presented.
  • The patient exhibited severe renal and hepatic dysfunction.
  • Autopsy revealed microvesicular fatty change in the liver.

Findings:

  • This case represents a fatal instance of NSAID-associated multisystem failure.
  • The presence of microvesicular fatty change in the liver is a distinct histopathologic finding.
  • This specific liver pathology has not been previously linked to NSAID-induced multisystem failure.

Implications:

  • This case underscores the potential for severe toxicity from NSAIDs, even in young individuals.
  • The unique liver finding suggests a specific mechanism of tolmetin toxicity.
  • Further research is warranted to elucidate the pathogenesis of NSAID-induced microvesicular steatosis and multisystem failure.

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