title: Haemodialysis in acute paracetamol poisoning.
abstract: A woman aged 23 years presented late with clinical and biochemical features of a life-threatening paracetamol (acetaminophen) overdose. Despite instigating N-acetylcysteine treatment, due to evidence of mitochondrial dysfunction together with an exceedingly high paracetamol level, the decision was made to dialyse the patient acutely to remove the parent drug. This was highly effective, and with on-going supportive care, the patient made a full recovery without the need for transplantation. This case highlights the role of extracorporeal therapy as a treatment option in selected cases of paracetamol overdose, consistent with the international guidelines.
authors.affiliation: Department of Nephrology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
authors.forename: L
authors.initials: L
authors.lastname: Serjeant
authors.affiliation: Department of Nephrology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Evans
authors.affiliation: Department of Hepatology, Cambridge University Hospitals NHS Trust, Cambridge, UK.|Anne McLaren Laboratory, Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK.
authors.forename: F
authors.initials: F
authors.lastname: Sampaziotis
authors.affiliation: Department of Nephrology, Cambridge University Hospitals NHS Trust, Cambridge, UK.|Nuffield Department of Surgical Sciences, Transplantation Research Immunology Group, University of Oxford, Oxford, UK.
authors.forename: W G
authors.initials: WG
authors.lastname: Petchey
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000111:Acetylcysteine / Q000627:therapeutic use*; D000140:Acidosis, Lactic / Q000139:chemically induced / Q000628:therapy*; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000628:therapy*; D062787:Drug Overdose / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D006435:Renal Dialysis / Q000379:methods*; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D016166:Free Radical Scavengers; D000082:Acetaminophen; D000111:Acetylcysteine