Paracetamol overdose
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Liver failure in a pregnant woman: case report A 25-year-old pregnant woman developed liver failure after taking an overdose of paracetamol [acetaminophen]. The woman, who was 30 weeks pregnant, consumed 24g of paracetamol, and was hospitalised 18 hours later. On admission, her blood paracetamol concentration was 55 mg/L, confirming a risk of liver toxicity. The woman received IV acetylcysteine. The next day, she was admitted to the ICU because of moderate hepatic cytolysis. Laboratory tests showed the following: AST 234 IU, ALT 104 IU, prothrombin 40%, factor V 31% and total bilirubin 31 mg/L. She continued to receive acetylcysteine. However, the hepatic cytolysis worsened up to 48 hours, with clinical and biological signs of hepatocellular failure, indicating stage I encephalopathy (AST 4000 IU, ALT 2400 IU, prothrombin 21% and factor V 20%). Her progress was good, and she was transferred to the maternity unit on her sixth day in hospital. She became febrile, suggesting chorioamniotitis, and underwent emergency caesarean section. She gave birth to a girl weighing 1700g with an Apgar score of 8-9-9. The neonate required tracheal intubation for respiratory distress, but was extubated after 5 days, and had no liver damage. Payen C, et al. Acute paracetamol overdose during pregnancy: A case report. [French]. Archives de Pediatrie 18: 1100-1102, No. 10, Oct 2011. Available from: URL: http://dx.doi.org/10.1016/j.arcped.2011.07.005 [French; summarised from a 803064351 translation] - France
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Reactions 17 Dec 2011 No. 1382
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