Acetaminophen (Paracetamol) induced acute liver failure – A social problem in an era of increasing tendency to self-treatment

Tadeusz Wróblewski 1, Konrad Kobryń 1, Sławomir Kozieł 1, Urszula Ołdakowska-Jedynak 2, Jarosław Pinkas 3, Roman Danielewicz 4, Bogna Ziarkiewicz-Wróblewska 5, Marek Krawczyk 1
1 - Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland
2 - Liver and Internal Medicine Unit of Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland
3 - 1. Centre of Postgraduate Medical Education, Warsaw Poland 2. Ministry of Health, Warsaw, Poland
4 - 1. Polish Transplant Coordinating Center “Poltransplant”, Warsaw, Poland 2. Department of Surgical and Transplant Nursing, Medical University of Warsaw, Poland
5 - Department of Pathology, Medical University of Warsaw, Poland
Ann Agric Environ Med
2015; 22 (4):
ICID: 1185790
Article type: Original article
Introduction.The widespread availability of medication without prescription, so-called over the counter (OTC), and the rapid development of health consciousness of Poles is associated with broad access to medical information in the mass media. This causes patients to recognize their own disease, cancel doctor’s appointments, and begin self-treatment. This time and money-saving behavior, often signaled by pain, usually leads to the treatment of symptoms alone, without seeking the cause of the disease.The aim of the study was to present life-threatening paracetamol poisoning, and the treatment of acute liver failure.
Material and Methods. In 2002–2014, 35 patients were hospitalized due to acute paracetamol poisoning: 17 female and 18 male patients aged between 17–59 (mean 32.3 years). Patients were treated in the surgical intensive care unit, where their parameters of liver and renal function were continuously monitored. If there was no improvement in the liver function, patients underwent albumin dialysis with the Prometheus system and were qualified for liver transplantation (LTx).
Results. 26 patients were treated pharmacologically and 7 out of 9 patients who underwent LTx were dialyzed. Overall, 11 patients had 26 albumin dialysis in total; 4 patients died – 1 post-transplant and 3 pre-transplant.
Conclusions. Paracetamol is the cause of many poisonings resulting from the lack of public awareness about toxic interactions with alcohol, and suicide attempts. Acetaminophen-induced acute liver failure concerns a small percentage of patients but can be successfully treated with albumin dialysis, and in extreme cases by liver transplantation.
DOI: 10.5604/12321966.1185790
PMID 26706992 - click here to show this article in PubMed

Recommend this article to:


Related articles in IndexCopernicus™
     acetaminophen poisoning [0 related records]
     over the counter drugs [0 related records]
     Liver Transplantation [601 related records]
     acute liver failure [30 related records]


Related articles

J Martínez, S Besa,
Gastrointestinal neuroendocrine tumor with unresec...
Gastrointestinal neuroendocrine tumors (NET) frequently present with unresectable hepatic metastases, which poses a barrier for curative treatment. Resection of the primary tumor and subsequent orthotopic liver transplantation (OLT) has been proposed...
T Grezzana Filho, A Chedid,
Liver allografts from donors with peritoneal conta...
Organs from deceased donors with traumatic abdominal injury, peritoneal contamination and open abdomen are usually discarded due to risks of transmission of severe infections to the recipient. There are no specific recommendations regarding organ uti...
P Czubkowski, J Cielecka-Kuszyk,
The limited prognostic value of liver histology in...
Background and rationale for the study. The aim of the study was to determine the prognostic value of histopathological findings with special care to the severity of liver fibrosis at the moment of hepatoportoenterostomy (HPE) in children with biliar...