Paracetamol-induced cholestatic and granulomatous liver injuries.
OBJECTIVE
To describe uncommon (previously unreported) types of adverse liver reactions to paracetamol.


METHODS
In addition to describing patients, with uncommon types of liver reactions to paracetamol, admitted to our hospitals, we surveyed all the liver reactions to paracetamol reported to the Swedish Adverse Drug Reactions Advisory Committee from 1973 to 1993.


METHODS
The Swedish population of 8 million inhabitants.


METHODS
Extensive medical evaluation.


RESULTS
We found one case with a cholestatic liver reaction and one with granulomatous hepatitis. The reactions were probably idiosyncratic and took several months to disappear.


CONCLUSIONS
In addition to the well-known dose-related toxic liver damage paracetamol may rarely cause non-dose-related severe, prolonged cholestasis or granulomatous hepatitis with cirrhosis.
Lindgren
A
A
Department of Internal Medicine, University of Göteborg, Sahlgrenska Hospital, Sweden.
Aldenborg
F
F
Norkrans
G
G
Olaison
L
L
Olsson
R
R
D000082:Acetaminophen / Q000009:adverse effects*; D000208:Acute Disease; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002779:Cholestasis / Q000139:chemically induced*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006099:Granuloma / Q000139:chemically induced*; D006801:Humans; D008297:Male; D013548:Sweden
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen