title: Iron and acetaminophen a fatal combination?
abstract: Intentional iron overdose in adults is uncommon. Clinical consequences are variable and depend on the quantity of iron ingested and the delay to treatment. Severe iron overdose can lead to multi-organ failure and acute hepatic necrosis. Here, we report three cases of polypharmacy overdose including iron resulting in acute liver failure. Despite maximum supportive care including liver transplantation in two cases, all patients died. Iron poisoning may have an additive toxic effect in drug-induced acute liver failure and worsen outcome.
authors: Institute of Liver Studies, King's College Hospital, London, UK.
authors: Vinod K
authors: VK
authors: Audimoolam
authors: Julia
authors: J
authors: Wendon
authors: William
authors: W
authors: Bernal
authors: Nigel
authors: N
authors: Heaton
authors: John
authors: J
authors: O'Grady
authors: Georg
authors: G
authors: Auzinger
mesh_terms: D000059:Accidents; D000082:Acetaminophen / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001921:Brain / Q000473:pathology; D004008:Diclofenac / Q000633:toxicity*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism* / Q000633:toxicity*; D017114:Liver Failure, Acute / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D009181:Mycoses / Q000382:microbiology; D011379:Prognosis; D018805:Sepsis / Q000382:microbiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D004008:Diclofenac; D000082:Acetaminophen; D007501:Iron