title: Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction.
abstract: Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We report a case that was erroneously managed as HELLP syndrome before a paracetamol overdose was diagnosed. This case highlights current practice in managing paracetamol overdose and focuses on the importance of addressing mental health issues to mitigate the risk of self-harm in pregnancy.
authors.affiliation: Department of Anaesthetics, Plymouth Hospitals NHS Trust, Derriford, Plymouth, Devon, UK. Electronic address: alexmills2@nhs.net.
authors.forename: A T
authors.initials: AT
authors.lastname: Mills
authors.affiliation: Department of Anaesthetics, Plymouth Hospitals NHS Trust, Derriford, Plymouth, Devon, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Davidson
authors.affiliation: Department of Anaesthetics, Plymouth Hospitals NHS Trust, Derriford, Plymouth, Devon, UK.
authors.forename: P
authors.initials: P
authors.lastname: Young
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D002585:Cesarean Section; D056486:Chemical and Drug Induced Liver Injury / Q000628:therapy*; D003937:Diagnosis, Differential; D062787:Drug Overdose / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D049590:Postpartum Period; D011247:Pregnancy
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
keywords: HELLP syndrome; Liver dysfunction; Paracetamol; Toxicity