title: Fatal acetaminophen poisoning with evidence of subendocardial necrosis of the heart.
abstract: The authors describe a case of fatal acetaminophen overdose which occurred in a 16-year-old female. Her serum acetaminophen concentration 11.5 h postingestion was 154 mg/L. Antidotal therapy was unsuccessful, and after 9 days she died. Autopsy findings included centrilobular zonal liver necrosis, acute proximal renal tubular necrosis, and diffuse alveolar pulmonary damage. Her heart was transplanted into a young woman with congenital heart disease. The recipient expired 14 days after the transplant as a result of sepsis complicating bowel ischemia. The transplanted heart showed extensive subendocardial myocyte necrosis related to acetaminophen toxicity and not rejection.
authors.affiliation: Department of Pathology, Medical College of Virginia, Richmond.
authors.forename: L M
authors.initials: LM
authors.lastname: Price
authors.forename: A
authors.initials: A
authors.lastname: Poklis
authors.forename: D E
authors.initials: DE
authors.lastname: Johnson
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000293:Adolescent; D062787:Drug Overdose / Q000473:pathology; D004699:Endocardium / Q000473:pathology*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D013405:Suicide
chemical_list: D000082:Acetaminophen