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Hepatotoxicity induced by acute and chronic paracetamol overdose in children: Where do we stand?

Hoi Yan Tong1, Nicolás Medrano1, Alberto Manuel Borobia1

  • 1Department of Clinical Pharmacology, Hospital Universitario La Paz, IdiPAZ, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.

World Journal of Pediatrics : WJP
|July 27, 2016
PubMed

Insights

Chronic paracetamol poisoning poses a significant risk for pediatric hepatotoxicity and acute liver failure. Delayed medical attention in these cases is a critical factor, necessitating increased clinical suspicion.

Area of Science:

  • Pediatric Toxicology
  • Hepatology
  • Emergency Medicine

Background:

  • Limited data exist on hepatotoxicity from acute or chronic paracetamol poisoning in children.
  • Existing paracetamol poisoning management guidelines may have weaknesses.

Purpose of the Study:

  • To investigate the incidence and characteristics of paracetamol poisoning in pediatric patients.
  • To assess the risk of hepatotoxicity and acute liver failure associated with acute versus chronic paracetamol poisoning in children.

Main Methods:

  • Retrospective study of pediatric patients (<18 years) with measurable paracetamol levels.
  • Data collected from emergency department visits for suspected paracetamol overdose between 2005 and 2010.
  • Analysis of poisoning causes, time to medical care, and incidence of hepatotoxicity.

Main Results:

  • Ninety-two pediatric cases of suspected paracetamol poisoning were identified.
  • Chronic poisoning cases showed a higher frequency of hepatotoxicity (7/8) and acute liver failure (3/8) compared to acute poisoning (1/49).
  • Average time to medical care was significantly longer for chronic poisoning (52.3 hours) than acute poisoning (6.83 hours).

Conclusions:

  • Chronic paracetamol poisoning is a significant risk factor for hepatotoxicity and acute liver failure in children.
  • Delayed medical intervention may contribute to adverse outcomes.
  • Clinicians require a heightened clinical suspicion for chronic paracetamol poisoning in pediatric patients.
Abstract

Keywords:
acute liver failurehepatotoxicityparacetamolpoisoning

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