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Acute paracetamol poisoning.

A T Proudfoot, N Wright

    British Medical Journal
    |September 5, 1970
    PubMed
    Summary
    This summary is machine-generated.

    Acute paracetamol poisoning can cause severe liver damage, with over 15g ingestion leading to toxicity in most patients. Renal failure and other complications may also occur, highlighting the critical need for prompt medical attention.

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    Area of Science:

    • Toxicology
    • Hepatology
    • Nephrology

    Background:

    • Paracetamol (acetaminophen) overdose is a common clinical problem.
    • Significant liver damage is a known complication of acute paracetamol poisoning.
    • The potential for renal involvement in paracetamol toxicity requires further investigation.

    Purpose of the Study:

    • To investigate the spectrum of organ damage in acute paracetamol poisoning.
    • To identify the dose threshold for paracetamol-induced liver damage.
    • To explore the association between paracetamol overdose and renal failure.

    Main Methods:

    • Retrospective analysis of 41 cases of acute paracetamol poisoning.
    • Clinical assessment of patient outcomes, including mortality and jaundice.

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  • Biochemical testing for hepatocellular damage and renal function.

    • Main Results:

    • One fatality occurred due to gastrointestinal hemorrhage and massive liver necrosis.
    • Hepatocellular damage was evident in 13 patients, with jaundice in three.
    • Liver damage occurred in most patients ingesting over 15g of paracetamol.
    • One patient with liver damage also experienced renal failure due to acute tubular necrosis, suggesting a link to paracetamol overdose.
    • Severe poisoning was complicated by hypoglycemia and metabolic acidosis.

    Conclusions:

    • Acute paracetamol poisoning can lead to severe, potentially fatal, liver damage.
    • Renal failure may be an additional consequence of paracetamol overdosage.
    • The rapid fall in plasma para-aminophenol levels limits the effectiveness of current elimination procedures in preventing hepatic damage.