title: Potentiation of acetaminophen hepatotoxicity by phenytoin, leading to liver transplantation.
abstract: 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.
authors.affiliation: Division of Gastroenterology and Hepatobiliary Diseases, Department of Surgery, New York Medical College, Westchester Medical Center, Valhalla, New York, USA. suchinmdrn@aol.com
authors.forename: Scott M
authors.initials: SM
authors.lastname: Suchin
authors.forename: David C
authors.initials: DC
authors.lastname: Wolf
authors.forename: Young
authors.initials: Y
authors.lastname: Lee
authors.forename: Gita
authors.initials: G
authors.lastname: Ramaswamy
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Sheiner
authors.forename: Marcelo
authors.initials: M
authors.lastname: Facciuto
authors.forename: Michael R
authors.initials: MR
authors.lastname: Marvin
authors.forename: Leona
authors.initials: L
authors.lastname: Kim-Schluger
authors.forename: Edward
authors.initials: E
authors.lastname: Lebovics
mesh_terms: 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*
chemical_list: D018712:Analgesics, Non-Narcotic; D000927:Anticonvulsants; D000082:Acetaminophen; D010672:Phenytoin