title: [Risk of acute hepatic insufficiency in children due to chronic accidental overdose of paracetamol (acetaminophen)].
abstract: Two girls aged 4 and 3 years, respectively, experienced acute liver failure due to accidental ingestion of supratherapeutic doses of paracetamol (90 mg/kg/day or more). Recognition of chronic paracetamol intoxication as a cause of acute hepatic failure is often delayed. It is important to consider the possibility of paracetamol-induced hepatotoxicity because many patients will recover if treated with N-acetylcysteine, as did both of these children. Patients with acute liver failure due to chronic paracetamol intoxication present with very high transaminase levels (> 4000 U/l), disproportionately low total bilirubin levels (< 200 micromol/l) and often hypoglycaemia.
authors.affiliation: Afd. Kindergeneeskunde, Universitair Medisch Centrum St Radboud, Postbus 6101, 6500 HB Nijmegen. p.hameleers@cukz.umcn.nl
authors.forename: P
authors.initials: P
authors.lastname: Hameleers-Snijders
authors.forename: M
authors.initials: M
authors.lastname: Hogeveen
authors.forename: J A M
authors.initials: JA
authors.lastname: Smeitink
authors.forename: C
authors.initials: C
authors.lastname: Kramers
authors.forename: J M Th
authors.initials: JM
authors.lastname: Draaisma
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000111:Acetylcysteine / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D002675:Child, Preschool; D062787:Drug Overdose; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D008099:Liver / Q000378:metabolism; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011379:Prognosis; D000637:Transaminases / Q000097:blood
chemical_list: D018712:Analgesics, Non-Narcotic; D016166:Free Radical Scavengers; D000082:Acetaminophen; D000637:Transaminases; D000111:Acetylcysteine