Potentiation of acetaminophen hepatotoxicity by phenytoin, leading to liver transplantation.
We report the case of a 22-year-old man who developed fulminant hepatic failure 3 days after an intentional acetaminophen overdose. The patient had a history of a seizure disorder for which he was taking phenytoin. The acetaminophen level at presentation was in the "nontoxic" range. Emergent liver transplantation was performed 4 days after the ingestion. This is the first reported case of successful liver transplantation for acetaminophen-induced fulminant hepatic failure in the setting of phenytoin therapy.
Suchin
Scott M
SM
Division of Gastroenterology and Hepatobiliary Diseases, Department of Surgery, New York Medical College, Westchester Medical Center, Valhalla, New York, USA. suchinmdrn@aol.com
Wolf
David C
DC
Lee
Young
Y
Ramaswamy
Gita
G
Sheiner
Patricia A
PA
Facciuto
Marcelo
M
Marvin
Michael R
MR
Kim-Schluger
Leona
L
Lebovics
Edward
E
D000082:Acetaminophen / Q000506:poisoning*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D000927:Anticonvulsants / Q000494:pharmacology*; D004357:Drug Synergism; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D010672:Phenytoin / Q000494:pharmacology*
D018712:Analgesics, Non-Narcotic; D000927:Anticonvulsants; D000082:Acetaminophen; D010672:Phenytoin