title: Acute liver failure following therapeutic paracetamol administration in patients with muscular dystrophies.
abstract: Clinically significant liver damage in patients taking therapeutic doses of paracetamol is very rare. We report two cases of fulminant hepatic failure caused by therapeutic (4 g x day(-1)) paracetamol administration on our Intensive Care Unit. Both patients had a muscular dystrophy and presented with a chest infection on a background of endstage neuromuscular respiratory failure. We also noted one further similar case in the literature and suggest a relationship between muscular dystrophy and paracetamol-induced hepatotoxicity. In this report we discuss in detail possible mechanisms that may account for this apparent association, which include altered pharmacokinetics, reduced glutathione stores, malnutrition and hypoxic injury.
authors: Cumberland Infirmary, Newtown Road, Carlisle, CA2 7HY, UK. brettpearce@doctors.org.uk
authors: B
authors: B
authors: Pearce
authors: I S
authors: IS
authors: Grant
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000209:etiology*; D008297:Male; D009136:Muscular Dystrophies / Q000150:complications*; D012131:Respiratory Insufficiency / Q000150:complications
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen