title: [Case report of repeated acetaminophen overdosing with various symptoms].
abstract: A 32-yr-old woman with acute gastritis and migraine used Naron commonly (the principal ingredients are acetaminophen and bromvalerylurea) and had been taking about 3g of acetaminophen daily for several days before admission. She was hospitalized with severe diffuse abdominal pain. On physical examination she had a peritoneal sign and laboratory studies showed elevated liver enzymes, hypophosphatemia, hypokalemia and low blood urea nitrogen(BUN). Serum acetaminophen level was 5.5 microg/mL on admission, so she seemed to be suffered from not only single ingestion but also repeated overdosing. Although we needed for aggressive phosphate and potassium repletion for about a week, all symptoms were distinguished after she quitted acetaminophen ingestion. In addition to hepatic dysfunction, renal failure and disseminated intravascular coagulopathy, we should pay attention to various symptoms like in this case when treating for a acetaminophen poisoning.
authors.affiliation: Department of Intensive Care and Emergency Medicine, Showa General Hospital.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kojima
authors.forename: Jyunnrou
authors.initials: J
authors.lastname: Ishida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inagawa
authors.forename: Yasusei
authors.initials: Y
authors.lastname: Okada
authors.forename: Michirou
authors.initials: M
authors.lastname: Machida
authors.forename: Taizou
authors.initials: T
authors.lastname: Terada
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000082:Acetaminophen / Q000506:poisoning*; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced; D017674:Hypophosphatemia / Q000139:chemically induced; D012008:Recurrence; D051437:Renal Insufficiency / Q000139:chemically induced*
chemical_list: D000082:Acetaminophen